MTHFR C677T多态性与苯磺酸左旋氨氯地平联用不同剂量叶酸治疗高血压伴焦虑老年患者的疗效分析  

CURATIVE EFFECT ANALYSIS OF MTHFR C677T POLYMORPHISM AND FOLIC ACID INTERVENTION WITH LEVAMLODIPINE BESYLATE IN OLD HYPERTENSION PATIENTS WITH ANXIETY

作　　者：张菘 周骥 王怀奇[1] 唐剑萍[1] 侯艾林[1] 严小玲[1] 虞宝中 贺汉军 ZHANG Song;ZHOU Ji;WANG Huaiqi;TANG Jianping;HOU Ailin;YAN Xiaoling;YU Baozhong;HE Hanjun(Department of Pharmaceutical,The First People's Hospital of Guangyuan,Guangyuan 628017,China)

机构地区：[1]四川省广元市第一人民医院药学部,628017

出　　处：《中国煤炭工业医学杂志》2022年第4期406-411,共6页Chinese Journal of Coal Industry Medicine

基　　金：四川省医学会高血压(施慧达)专项科研课题(编号:2018SHD3-10)。

摘　　要：目的 观察MTHFR C677T多态性与苯磺酸左旋氨氯地平联用不同剂量叶酸治疗高血压伴焦虑老年患者的疗效。方法 高血压伴焦虑患者随机分为观察组和对照组,研究组给予叶酸联用苯磺酸左旋氨氯地平;对照组单独给予苯磺酸氨氯地平。根据检测的MTHFR C677T基因型调整叶酸用量,检测患者血压、SAS评分、Hcy、NO、ET-1等血管内皮因子治疗前后变化。结果 110例中(研究组55例,对照组55例),93例根据SAS评分存在焦虑。治疗前二组患者基本资料差异均无统计学意义(均P>0.05)。第一阶段给予研究组加用0.8mg叶酸治疗1个月后,二组及二组间血压和SAS评分差异均无统计学意义(均P>0.05),但在研究组中,与治疗前比较Hcy和ET-1有下降趋势,NO有上升趋势(均P<0.05)。第二阶段根据患者MTHFR C677基因型个体化给予研究组叶酸个体化治疗一个月,第二阶段治疗后与第一阶段和对照组比较,Hcy、ET-1/NO、SAS评分和BP明显降低(P<0.01)。结论 高血压伴焦虑患者通过MTHFR C677T基因多态性个体化补充叶酸联用苯磺酸左旋氨氯地平能降低患者血管内皮损伤从而减轻患者焦虑、有效控制血压,降低患者不良临床风险。Objective To analysis of curative effect of levamlodipine besylate with folic acid in hypertension with anxiety.Methods The hyperpietics with anxiety were randomized by using a randomized controlled trial.Research group was given folic acid and levamlodipine besylate.Control group received levamlodipine besylate alone.And the dose of folic acid adjusted by gene type of the MTHFR C677 Polymorphism.Outcomes were evaluated after two-stage treatment with the different dose of folic acid.Both outcomes included the levels of Hcy, NO, ET-1,SAS and BP.Results Of one hundred and twenty-six participants(fifty-five with folic acid, fifty-five controls),ninety-three had over the SAS anxiety score.There was no significant difference in basic information between the two groups before treatment(P>0.05).Use the treatment(folic acid 0.8 mg) by one month later, the first outcome of SAS,BP had no difference before and after the treatment(P>0.05),and had no obvious difference between the two groups(P>0.05),but Hcy and ET-1 had a decreasing tendency and the NO had an increasing tendency in intervention group(P<0.05).Dose of folic acid were adjusted by gene type of the MTHFR C677 Polymorphism.One month later the levels of Hcy and ET1/NO significantly decreased in intervention group and lower than that of the first month group and control group(P<0.01).And the BP and SAS score were significantly lower in the second month group after treatment than those of first month treatment(P<0.01).Conclusion Compared with levamlodipine besylate alone, folic acid resulted in patients having fewer injury of vascular endothelial cells and less anxiety following therapy for hypertension.We have demonstrated that levamlodipine besylate with folic acid supplementation by MTHFR C677 T tested can improve clinical outcome in anxiety with hypertension.

关 键 词：苯磺酸左旋氨氯地平 叶酸 MTHFR C677T 焦虑 高血压 

分 类 号：R544[医药卫生—心血管疾病]