叶酸对老年高血压病患者血浆同型半胱氨酸水平和认知功能的影响  

Effect of Folic Acid on Plasma Homocysteine Level and Cognitive Function in Elder Patients With Hypertension

作　　者：吴俊[1] 王东霞[1] 陈雪梅[1] 方赟[1] 丁晓婧[1] 郭兆凌[1] 

机构地区：[1]南京市市级机关医院老年科,江苏省210018

出　　处：《中国循环杂志》2013年第8期581-585,共5页Chinese Circulation Journal

基　　金：南京市医学科技发展项目(YKK12204)

摘　　要：目的 :探讨叶酸对老年高血压病患者血浆同型半胱氨酸水平(Hcy)和认知功能的影响。方法 :入选2011-09至2012-07我院老年科住院高血压病患者146例,分为对照组[73例,年龄(75.7±7.8)岁]和干预组[73例,年龄(75.0±7.1)岁],两组患者同时接受高血压常规治疗,干预组在常规治疗基础上加用叶酸5 mg/d口服,测量入院后,治疗8周后Hcy水平,同时记录简易精神状态检查(MMSE)量表评分。临床合并疾病情况包括糖尿病和冠心病。结果 :治疗8周后与治疗前比较,干预组、对照组血压均明显降低(P<0.05),干预组治疗8周后血浆Hcy水平明显降低(P<0.05),同时明显低于对照组同期水平(P<0.05),对照组治疗前后血浆Hcy水平比较无明显差异(P>0.05)。干预组、对照组治疗8周后MMSE量表评分均较治疗前明显提高(P<0.05),干预组MMSE量表评分提高更加明显(P<0.05)。干预组3级高血压血浆Hcy明显高于1、2级高血压(P<0.05),MMSE量表评分明显低于1、2级高血压(P<0.05),治疗8周后血浆Hcy下降幅度明显>1、2级高血压(P<0.05)。老年高血压合并一种疾病和合并两种疾病血浆Hcy均明显高于单纯老年高血压病(P<0.05),MMSE量表评分明显低于单纯老年高血压病(P<0.05)。老年高血压合并一种疾病和合并两种疾病治疗8周后血浆Hcy下降幅度明显大于单纯老年高血压病(P<0.05)。结论 :叶酸能够明显降低老年高血压病患者血浆Hcy水平,显著改善认知功能。老年3级高血压和老年高血压伴临床疾患的患者使用叶酸治疗,更加有利于降低血浆Hcy水平,降低认知功能损害。Objective： To explore the effect of folic acid on plasma homocysteine （Hcy） level and cognitive function in the elder patients with hypertension. Methods： A total of 146 patients admitted in our hospital from 2011-09 to 2012-07 were randomly divided into 2 groups. Control group, n=73 patients with routine medication at the age of （75.7± 7.8） years and Treatment group, n=73 patients with routine medication plus oral folic acid （5 mg/day） at the age of （75.0 ~ 7.1） years. Plasma Hcy levels at admission and at 8 weeks after treatment were measured and cognitive function was evaluated by mini-mental state examination （MMSE） scale. Results： With 8 weeks treatment, the patient＇s blood pressure （BP） decreased in both groups; plasma Hcy level significantly decreased in Treatment group than it was before and it was much lower than that in Control group, all P〈0.05. Hcy level was similar before and after the treatment in Control group, P〉0.05. With 8 weeks treatment, MMSE score obviously improved in both groups and the improvement in Treatment group was higher than that in Control group, both P〈0.05. In Treatment group, plasma Hcy level in grade 3 patients was higher than those in grade 1, 2 patients and the treatment made more decreasing; while MMSE score in grade 3 patients was lower than those in grade 1, 2 patients, all P〈0.05. The elder hypertension with 1 or 2 complications had higher Hcy level and lower MMSE score than hypertension alone, both P〈0.05 and with S weeks treatment, the Hcy level decreased more in hypertension with complications, P〈0.05. Conclusion： Folic acid could significantly decrease plasma Hcy level and improve cognitive function in elder hypertension patients.

关 键 词：叶酸 老年高血压 同型半胱氨酸 认知功能 

分 类 号：R541[医药卫生—心血管疾病]