体检人群同型半胱氨酸血症与H型高血压的筛查及叶酸干预治疗效果观察  

Screening of homocystinemia and H-type hypertension in health check-up populations and effect observation of folic acid intervention therapy

作　　者：陈晓红[1] 廖家有[2] 王齐芳 胡蓉[1] 谢东阳[2] 何华[1] 徐慧荣[1] 

机构地区：[1]赣南医学院第一附属医院检验科,江西赣州341000 [2]赣南医学院第一附属医院心血管内科,江西赣州341000 [3]赣南医学院第二附属医院心血管内科,江西赣州341000

出　　处：《现代医药卫生》2015年第15期2252-2255,共4页Journal of Modern Medicine & Health

基　　金：赣州市科技计划项目(49)

摘　　要：目的了解体检人群同型半胱氨酸（Hcy）的水平,观察叶酸对高同型半胱氨酸血症及依那普利联合叶酸、依那普利叶酸（固定复方）对H型高血压干预治疗效果。方法选择2013年1-12月于赣南医学院第一附属医院体检中心体检的10 400名健康体检人群作为研究对象,检测其Hcy水平,筛查单纯高同型半胱氨酸血症和H型高血压,并进行干预治疗。选取其中单纯高同型半胱氨酸血症患者100例,给予叶酸治疗;H型高血压患者200例,分成两组,分别给予依那普利联合叶酸干预治疗与依那普利叶酸（固定复方）干预治疗。治疗1、2、3个月后复诊,检测Hcy水平和测量坐位血压。结果 10 400名健康体检人群中,高Hcy者占23.08%（2 400/10 400）,其中单纯高同型半胱氨酸血症患者8.78%（913/10 400）,H型高血压患者14.30%（1 487/10 400）。单纯高同型半胱氨酸血症患者经叶酸干预治疗1、2、3个月后Hcy水平降低,差异均有统计学意义（P〈0.05或0.01）。H型高血压患者经依那普利联合叶酸、依那普利叶酸（固定复方）治疗后,Hcy与血压水平均较治疗前降低,差异均有统计学意义（P〈0.05或0.01）;且2种方法治疗后Hcy、血压水平比较,差异无统计学意义（P〉0.05）。结论在健康体检者中筛查出较高比例的单纯高同型半胱氨酸血症和H型高血压患者。建议在常规体检中重视对Hcy水平的检测,对筛查高同型半胱氨酸血症及早期发现H型高血压,并进行早期叶酸干预治疗具有重要意义。Objective To understand the level of plasma homocysteine（Hcy） in health check-up populations and to observe the curative effect of folate intervention on hyperhomecysteinemia and enalapril and folic acid intervention on H-type hypertension. Methods 10 400 healthy individuals undergoing physical examination in the physical examination center of the First Affiliated Hospital of Ganan Medical College from January to December 2013 were selected as the research subjects. The Hcy level was detected and the simple hyperhomecysteinemia and H-type hypertension were screened and the intervention therapy was conducted. Among them,100 cases of simple hyperhomecysteinemia were selected and given the folic acid therapy;200 cases of H-type hypertension were divided into the two groups and respectively given the interventional therapy of enalapril combined with folic acid or enalapril folic acid（fixed compound） intervention therapy. Plasma Hcy was re-checked and sitting blood pressure was measured in 1,2,3 months of treatment. Results Among 10 400 cases of healthy examination population, high Hcy accounted for 23.08%（2 400/10 400）,in which simple hyperhomecysteinemia was 8.78%（913/10 400）,H-type hypertension was 14.30%（1 487/10 400）. Plasma Hcy level in simple hyperhomecysteinemia patients was decreased after 1,2 and 3 months of folic acid intervention therapy,the differences were statistically significant（P〈0.05 or 0.01）. Plasma Hcy and blood pressure level after enalapril combined with folic acid intervention therapy or enalapril folic acid（fixed compound） intervention therapy in the H-type hypertension patients were decreased compared with before treatment,the differences were statistically significant（P〈0.05 or 0.01）;and the differences between two methods of Hcy and blood pressure levels had no statistically significance（P〉0.05）. Conclusion The higher proportion of simple hyperhomecysteinemia and H-type hypertension were screened out among the physical examination population. It is

关 键 词：高半胱氨酸 高同种半胱氨酸血症 高血压 叶酸 

分 类 号：R589.3[医药卫生—内分泌]