叶酸对H型高血压患者颈总动脉内膜中层厚度原因分析.docVIP

叶酸对H型高血压患者颈总动脉内膜中层厚度原因分析 　摘 要 目的：研究H型高血压患者颈总动脉内膜中层厚度（intima media thickness，IMT）的变化以及叶酸对H型高血压患者的血压和颈总动脉IMT的影响。方法：203例近1月未服降压药的I～II级原发性高血压患者，依据血浆同型半胱氨酸（homocysteine，Hcy）水平分为H型高血压组（Hcyge;10 ?mol/L）和普通高血压组（Hcylt;10 ?mol/L），把H型高血压患者随机分为叶酸治疗组（试验组）和常规治疗组（对照组），对照组口服依那普利10 mg/d，试验组同时服用叶酸片2.5 mg/d，在治疗前和治疗6个月后复查Hcy水平、测定双侧颈总动脉IMT。结果：H型高血压患者颈总动脉IMT高于普通高血压患者，差异具有统计学意义;治疗6个月后，与对照组相比，试验组患者血压没有进一步下降，但是Hcy和颈总动脉IMT降低，差异具有统计学意义。结论：Hcy可能是颈总动脉粥样硬化的因素之一;叶酸可降低H型高血压患者的Hcy、逆转颈总动脉IMT的增厚。 　关键词 叶酸 H型高血压 颈总动脉 内膜中层厚度 　中图分类号：R977.22; R544.1 文献标识码：B 文章编号：1006-1533（2014）23-0049-04 　 Effect of folic acid tablets on the intima media thickness 　of carotid artery in patients with H-type hypertension 　WANG Zhancheng1， JI Wenhui2， RUAN Changwu1， FANG Ningyuan3， CHU Shaoli4 　（1. Department of Cardiovascular， Shanghai Eighth People s Hospital， Shanghai 200235， China; 2. Department of Internal Medicine， Huajing Community Health Service Center of Xuhui District， Shanghai 200231， China; 3. Department of Geriatrics， Renji Hospital Affilicated to Shanghai Jiao Tong University， Shanghai 200001， China; 4. Shanghai Institute of Hypertension， Shanghai 200025， China） 　ABSTRACT Objective： To study the changes of the intima media thickness （IMT） of common carotid artery and the effect of folic acid on blood pressure and IMT in patents with H-type hypertension. Methods： Two hundred and three cases of patients with grade I～II primary hypertension without taking any antihypertensive drug lately within 1 month were divided into an H-type hypertension group （Hcyge;10 mmol/L） and a common hypertension group （Hcylt;10 mmol/L） according to the level of plasma homocysteine （Hcy）. The H-type hypertensive patients were randomly divided into an experimental group treated with folic acid and a control group. Enalapril tablets were given to all the patients with H-type hypertension at 10 mg/d and additionally folic acid tablets to the experimental group at 2.5 mg/d. Hcy concentrations and the IMT of bilateral common carotid