叶酸辅助治疗对H型高血压患者血清同型半胱氨酸和血压负荷及血压变异性的影响
협산보조치료대H형고혈압환자혈청동형반광안산화혈압부하급혈압변이성적영향
Effect of folic acid on homocysteine, blood pressure load and blood pressure variability in patients with type H hypertension
  • 万方数据
    中国医药 중국의약
    China Medicine
    2015年 12期 1753-1757 ,共5页

    秦景梅%商秀芳%丛晓荣

    진경매%상수방%총효영

    H 型高血压%叶酸%同型半胱氨酸%血压负荷%血压变异性 H 型高血壓%葉痠%同型半胱氨痠%血壓負荷%血壓變異性
    H 형고혈압%협산%동형반광안산%혈압부하%혈압변이성
    Type H hypertension%Folic acid%Homocysteine%Blood pressure load%Blood pressure variability
    目的 观察叶酸辅助治疗对H型高血压患者血清同型半胱氨酸(Hcy)、血压负荷和血压变异性(BPV)的影响.方法 选择2014年1-12月在山东省滕州市中心人民医院就诊的H型高血压患者178例,按随机数字表及就诊顺序分为观察组(93例)和对照组(85例),对照组给予常规降压治疗,观察组在常规治疗基础上给予叶酸0.8 mg/d口服,服药8周.分析比较2组服药前及服药4、8周后血清Hcy和血压负荷(包括白昼收缩压负荷、白昼舒张压负荷、夜间收缩压负荷、夜间舒张压负荷)、BPV(包括白昼收缩压变异性、白昼舒张压变异性、夜间收缩压变异性、夜间舒张压变异性)的变化,并观察不良反应发生情况.结果 2组患者均未见明显不良反应发生.服药前2组Hcy水平比较差异无统计学意义(P＞0.05);服药4、8周后观察组Hcy均明显低于服药前[(14.2±5.2)、(9.7±2.0) μmol/L比(20.4 ±8.5) μmol/L]和对照组同时点[(18.4±7.3)、(18.6±7.4)μmol/L],差异均有统计学意义(均P＜0.05),服药8周后Hcy值降至正常范围.服药前和服药4、8周后2组间白昼、夜间血压负荷、BPV各指标比较差异均无统计学意义(均P＞0.05);服药4、8周后观察组和对照组白昼收缩压负荷、白昼舒张压负荷、夜间收缩压负荷、夜间舒张压负荷、白昼收缩压变异性、白昼舒张压变异性、夜间收缩压变异性、夜间舒张压变异性均低于服药前[观察组:(11.3±5.2)％、(6.3±1.6)％比(59.3±15.5)％,(12.4±3.5)％、(7.4±2.6)％比(51.4±13.7)％,(12.5±4.0)％、(6.6±1.3)％比(41.9±16.4)％,(9.7±3.1)％、(7.6±2.7)％比(39.2±1 1.6)％,(1 1.1±5.5)、(6.8±2.0)mmHg(1 mmHg =0.133 kPa)比(17.5±6.1)mmHg,(7.3±2.0)、(3.8±1.3)mmHg比(9.6±2.4)mmHg,(9.7±3.6)、(6.5±2.3) mmHg比(14.6±7.3) mmHg, (6.5±2.6)、(2.8±1.7) mmHg比(10.2±4.7) mmHg;对照组:(12.3±7.2)％、(8.3±1.7)％比(50.3±17.0)％,(10.4±3.7)％、(7.4±2.5)％比(42.4±12.5)％,(12.6±7.6)％、(9.6±3.0)％比(42.6±17.3)％,(10.0±4.2)％、(7.7±1.9)％比(37.6±14.7)％,(12.1±8.5)、(9.3±2.0) mmHg比(18.3±7.0) mmHg, (7.2±3.2)、(4.4±1.5)mmHg比(9.4±2.5)mmHg,(1 1.7±7.7)、(7.3±2.2) mmHg比(15.6±7.3) mmHg,(6.6±3.5)、(3.1±2.1)mmHg比(9.3±4.7) mmHg],差异均有统计学意义(P＜0.05或P＜0.01).结论 叶酸治疗能明显降低H型高血压患者血清Hcy水平,但对血压负荷、BPV改善不明显.
    목적 관찰협산보조치료대H형고혈압환자혈청동형반광안산(Hcy)、혈압부하화혈압변이성(BPV)적영향.방법 선택2014년1-12월재산동성등주시중심인민의원취진적H형고혈압환자178례,안수궤수자표급취진순서분위관찰조(93례)화대조조(85례),대조조급여상규강압치료,관찰조재상규치료기출상급여협산0.8 mg/d구복,복약8주.분석비교2조복약전급복약4、8주후혈청Hcy화혈압부하(포괄백주수축압부하、백주서장압부하、야간수축압부하、야간서장압부하)、BPV(포괄백주수축압변이성、백주서장압변이성、야간수축압변이성、야간서장압변이성)적변화,병관찰불량반응발생정황.결과 2조환자균미견명현불량반응발생.복약전2조Hcy수평비교차이무통계학의의(P＞0.05);복약4、8주후관찰조Hcy균명현저우복약전[(14.2±5.2)、(9.7±2.0) μmol/L비(20.4 ±8.5) μmol/L]화대조조동시점[(18.4±7.3)、(18.6±7.4)μmol/L],차이균유통계학의의(균P＜0.05),복약8주후Hcy치강지정상범위.복약전화복약4、8주후2조간백주、야간혈압부하、BPV각지표비교차이균무통계학의의(균P＞0.05);복약4、8주후관찰조화대조조백주수축압부하、백주서장압부하、야간수축압부하、야간서장압부하、백주수축압변이성、백주서장압변이성、야간수축압변이성、야간서장압변이성균저우복약전[관찰조:(11.3±5.2)％、(6.3±1.6)％비(59.3±15.5)％,(12.4±3.5)％、(7.4±2.6)％비(51.4±13.7)％,(12.5±4.0)％、(6.6±1.3)％비(41.9±16.4)％,(9.7±3.1)％、(7.6±2.7)％비(39.2±1 1.6)％,(1 1.1±5.5)、(6.8±2.0)mmHg(1 mmHg =0.133 kPa)비(17.5±6.1)mmHg,(7.3±2.0)、(3.8±1.3)mmHg비(9.6±2.4)mmHg,(9.7±3.6)、(6.5±2.3) mmHg비(14.6±7.3) mmHg, (6.5±2.6)、(2.8±1.7) mmHg비(10.2±4.7) mmHg;대조조:(12.3±7.2)％、(8.3±1.7)％비(50.3±17.0)％,(10.4±3.7)％、(7.4±2.5)％비(42.4±12.5)％,(12.6±7.6)％、(9.6±3.0)％비(42.6±17.3)％,(10.0±4.2)％、(7.7±1.9)％비(37.6±14.7)％,(12.1±8.5)、(9.3±2.0) mmHg비(18.3±7.0) mmHg, (7.2±3.2)、(4.4±1.5)mmHg비(9.4±2.5)mmHg,(1 1.7±7.7)、(7.3±2.2) mmHg비(15.6±7.3) mmHg,(6.6±3.5)、(3.1±2.1)mmHg비(9.3±4.7) mmHg],차이균유통계학의의(P＜0.05혹P＜0.01).결론 협산치료능명현강저H형고혈압환자혈청Hcy수평,단대혈압부하、BPV개선불명현.
    Objective To observe the effect of folic acid on homocysteine (Hcy), blood pressure load (BPL) and blood pressure variability (BPV) in patients with type H hypertension.Methods One hundred and seventy-eight patients with type H hypertension were randomly divided into observation group (93 cases) receiving oral folic acid (0.8 mg) on the basis of conventional therapy and control group (85 cases) receiving conventional therapy.The treatment was lasted for 8 weeks.The Hcy level, BPL [day systolic blood pressure load (dSBPL),day diastolic blood pressure load (dDBPL), night systolic blood pressure load (nSBPL), night diastolic blood pressure load (nDBPL)] and BPV [day systolic blood pressure standard deviation (dSBPSD) , day diastolic blood pressure standard deviation (dDBPSD), night systolic blood pressure standard deviation (nSBPSD), night diastolic blood pressure standard deviation (nDBPSD)] were determined before, 4 and 8 weeks after treatment and compared between groups.The adverse reactions were also observed.Results No significant adverse reactions was found in both groups.The Hcy level was not significantly different before treatment between groups (P ＞0.05).Compared with those before treatment, the Hcy level was significantly reduced 4 and 8 weeks after treatment in observation group[(14.2 ± 5.2) , (9.7 ± 2.0) μmol/L vs (20.4 ± 8.5) μmol/L] , and was significantly lower than those in control group at the same time points [(18.4 ± 7.3), (18.6 ± 7.4) μmoL/L] (P ＜ 0.05);the Hcy level in observation group achieved the normal reference value 8 weeks after treatment.The BPL and BPV were not significantly different between groups before and after treatment (P ＞ 0.05).The dSBPL, dDBPL,nSBPL, nDBPL and dSBPSD, dDBPSD, nSBPSD, nDBPSD were all significantly decreased 4 and 8 weeks after treatment compared with those before treatment in observation group [(11.3 ± 5.2) ％, (6.3 ± 1.6) ％ vs (59.3±15.5)％;(12.4±3.5)％, (7.4±2.6)％ vs (51.4±13.7)％;(12.5±4.0)％, (6.6±1.3)％ vs (41.9±16.4)％;(9.7±3.1)％, (7.6±2.7)％ vs (39.2±11.6)％;(11.1 ±5.5), (6.8±2.0) mmHg vs (17.5 ±6.1) mmHg;(7.3 ±2.0), (3.8±1.3) mmHg vs (9.6 ±2.4) mmHg;(9.7 ±3.6), (6.5±2.3) mmHgvs (14.6±7.3) mmHg;(6.5±2.6), (2.8±1.7) mmHgvs (10.2±4.7)] and control group [(12.3±7.2)％, (8.3±1.7)％ vs (50.3±17.0)％;(10.4±3.7)％, (7.4±2.5)％ vs (42.4±12.5)％;(12.6±7.6)％, (9.6±3.0)％ vs (42.6±17.3)％;(10.0±4.2)％, (7.7±1.9)％ vs (37.6±14.7)％;(12.1 ±8.5), (9.3±2.0) mmHg vs (18.3±7.0) mmHg;(7.2±3.2), (4.4±1.5) mmHgvs (9.4±2.5) mmHg;(11.7 ±7.7), (7.3 ±2.2) mmHg vs (15.6 ±7.3) mmHg;(6.6±3.5), (3.1±2.1) mmHgvs (9.3±4.7) mmHg] (P＜0.05 or P ＜ 0.01).Conclusions Folic acid can effectively reduce the Hcy level in patients with type H hypertension, but has no significant effect on BPV and BPL.
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