叶酸联合复合维生素B对合并H型高血压的腔隙性脑梗死患者靶器官功能的保护作用  

Protective effect of folic acid combined with compound vitamin B on target organ functions in patients with lacunar infarction complicated with H type hypertension

作　　者：王冬英 姜海波[2] 周育苗[3] WANG Dongying;JIANG Haibo;ZHOU Yumiao(Department oflnternal Medicine, Hangzhou Geriatric Hospital, Zhejiang Province, Hangzhou 310022, China;D epartment of Neurology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China;Department of Neurology, Zhejiang Hospital, Hangzhou 310007, China)

机构地区：[1]浙江省杭州市老年病医院内科,杭州310022 [2]杭州师范大学附属医院神经内科,杭州310015 [3]浙江医院神经内科,杭州310007

出　　处：《中国临床药学杂志》2018年第3期159-163,共5页Chinese Journal of Clinical Pharmacy

基　　金：浙江省医药卫生一般研究计划(编号2014KYB017)

摘　　要：目的探讨叶酸联合复合维生素B对H型高血压合并腔隙性脑梗死患者靶器官功能的保护作用。方法收集2014年1月至2015年2月我院收治的合并H型高血压的腔隙性脑梗死患者86例,随机分为观察组和对照组,每组各43例。所有患者均给予降血压、营养神经等对症支持治疗。在此基础上,观察组加用叶酸(25 mg,po,qd)+复合维生素B(10 mg,po,bid);对照组仅给予复合维生素B。总疗程为24个月。观察2组患者心率、血压变异性,颈动脉内膜中膜厚度(IMT),左室质量指数(LVMI),肾小球滤过率,胱抑素C,颅内动脉狭窄程度和高半胱氨酸(Hcy)水平。结果 2组患者入院时Hcy水平之间差异无统计学意义(P> 0. 05)。与对照组比较,观察组治疗12、24个月时Hcy水平均显著降低(P <0. 01)。2组患者治疗前心率变异性[SDNN、SDANN、SDNN-Index、rMSSD、PNN50(%)]、胱抑素C、IMT、左室质量指数、24 h收缩压变异性等比较差异均无统计学意义(P> 0. 05)。治疗24个月时,与对照组比较,观察组患者心率变异性显著增加,胱抑素C、IMT、左室质量指数、24 h收缩压变异性明显降低(P <0. 05)。2组患者治疗前后肾小球滤过率、24 h舒张压变异性和颅内动脉狭窄程度之间差异均无统计学意义(P> 0. 05)。结论叶酸联合复合维生素B有助于降低合并H型高血压的腔隙性脑梗死患者Hcy水平,保护患者心血管和肾功能。AIM To investigate the protective effect of folic acid combined with compound vitamin B on target organ functions in patients with lacunar infarction complicated with H type hypertension. METHODS From January 2014 to February 2015, 86 patients with lacunar infarction complicated with H type hypertension were pro- spectively collected and they were randomly assigned into an observation group or a control group with 43 patients in each group. All patients were given antihypertensive and nerve nutrition supporting treatment, on the basis of this, the observation group received folic acid （25 mg,po, qd） and compound vitamin B （ 10 mg,po, bid）, while the control group received vitamin B only. And the total course of treatment was 24 months. The heart rate variability, blood pressure variability, intima-media thickness （IMT） , left ventricular mass index, glomerular filtration rate, cystatin C, intracranial artery stenosis and homocysteine （Hcy） levels were observed in the both groups. RESULTS There was no differences between the 2 groups in Hcy on admission （P 〉 0.05）. However, when compared with the control group, patients in the observation group got reduction in Hcy at 12 and 24 months since the beginning of the treatment （P 〈 0.01 ）. There were no significant differences between the 2 groups in heart rate variability [ SDNN, SDANN, SDNN-Index, rMSSD, PNNS0 （%） ] , cystatin C, IMT, left ventricular mass index and 24 h systolic pressure variability on admission （P 〉 0.05）. However, at 24 months when compared with control group, patients in the observation group got increased SDNN, SDANN, SDNN-Index, rMSSD and PNNS0 （ % ） , while they got reduction in cystatin C, IMT, left ventricular mass index and 24 h systolic pressure variability （P 〈 0.05）. The glomerular filtration rate, 24 h diastolic pressure variability and the degree of intracranial artery stenosis were not statistically different between the 2 groups before or after the treatment （P〉0. 05 ）. CONCLUSION

关 键 词：叶酸 复合维生素B H型高血压 腔隙性脑梗死 靶器官 保护作用 

分 类 号：R544.1[医药卫生—心血管疾病] R743.3[医药卫生—内科学]