叶酸对伴有高同型半胱氨酸血症高血压患者的脑梗死发病率的影响研究  

Effects of Folic Acid on the Incidence of Cerebral Infarction in Patients with Hyperhomocysteinemia Hypertension

作　　者：冯智敏[1,2] 雷露雯[1,2] 刘家欣[3] 

机构地区：[1]南方医科大学附属南海医院 [2]佛山市南海区人民医院,广东佛山528200 [3]广东药学院,广州510006

出　　处：《中国药房》2013年第26期2447-2449,共3页China Pharmacy

摘　　要：目的:探讨不同剂量的叶酸在治疗伴有高同型半胱氨酸血症(HHcy)的高血压患者中,对同型半胱氨酸(Hcy)的浓度及脑梗死发生率的影响。方法:收集我院2011-2012年H型高血压患者200例,在常规治疗的基础上随机分为对照组(未给予叶酸)、叶酸治疗A组(给予叶酸片1mg,qd)、叶酸治疗B组(给予叶酸片5mg,qd)。所有观察对象随访48周,分析患者治疗前、后的Hcy浓度及脑梗死发生率的情况。结果:叶酸治疗A组患者的Hcy浓度从治疗前的(21.63±8.5)μmol/L下降至治疗后的(15.14±5.95)μmol/L;叶酸治疗B组患者的Hcy浓度从治疗前的(23.98±5.44)μmol/L下降至治疗后的(16.79±3.80)μmol/L;对照组患者的Hcy浓度由治疗前的(21.87±5.49)μmol/L下降至治疗后的(21.68±5.43)μmol/L。叶酸治疗A组与叶酸治疗B组血Hcy显著降低,与对照组比较差异有统计学意义(F=29.048,P=0)。叶酸治疗A组发生脑梗死9例(13%),叶酸治疗B组发生脑梗死8例(12%),对照组发生脑梗死10例(15%),各叶酸治疗组与对照组比较差异均无统计学意义(χ2=0,P=1.00)。结论:口服叶酸片能降低H型高血压患者的Hcy浓度,但不呈剂量依赖性;在为期48周的随访期间未降低脑梗死的发生率。OBJECTIVE：To explore the effects of different doses of folic acid on homocysteine（Hcy）concentration and the incidence of cerebral infarction in patients with hyperhomocysteinemia（HHcy）hypertension. METHODS：200 cases of HHcy hypertension were collected from our hospital from 2011 to 2012. They were randomly divided into control group（not given folic acid）, folic acid treatment group A（Folic acid tablets 1 mg,qd）and folic acid treatment group B（Folic acid tablets 5 mg,qd）,based on conventional treatment. After 48 weeks of follow-up,the Hcy concentration and the incidence of cerebral infarction were analyzed statistically before and after treatment. RESULTS：The concentration of Hcy was decreased from（21.63±8.5）μmol/L to（15.14± 5.95）μmol/L in folic acid treatment group A,and from（23.98±5.44）μmol/L to（16.79±3.80）μmol/L in folic acid treatment group B . The concentration of Hcy was decreased from（21.87±5.49）μmol/L to（21.68±5.43）μmol/L in control group. In group A and group B with folic acid treatment,the concentration of Hcy was significantly reduced,there was statistically significant difference compared with control group（F=29.048,P=0.00）. 9 cases suffered from cerebral infarction in folic acid treatment group A （13%）,and 8 cases in folic acid treatment group B（12%）and 10 cases in control group（15%）. There was no statistical significance between folic acid treatment groups and control group（χ^2 =0,P=1.00）. CONCLUSIONS：Oral dose of folic acid can decrease the concentration of Hcy in patients with HHcy hypertension,but not in a dose-dependent manner. During 48 weeks of follow-up period,the incidence of cerebral infarction has no statistical difference.

关 键 词：高同型半胱氨酸血症 同型半胱氨酸 脑梗死 高血压 叶酸 

分 类 号：R969.3[医药卫生—药理学] R287[医药卫生—药学]