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    不同基因型H型高血压病人血压和血浆同型半胱氨酸水平比较及补充叶酸对其的影响

    Comparison of the blood pressure and plasma homocysteine levels in patients with different genotypes of H-type hypertension, and effects of folic acid supplementation

      摘要
    • 摘要:
      目的分析不同基因型H型高血压病人血压和血浆同型半胱氨酸（Hcy）水平及补充叶酸对其的影响。
      方法选取行常规降压治疗和叶酸治疗的H型高血压病人102例（观察组），根据不同基因分型进行分组，其中突变型为TT组，杂合型为CT组，野生型为CC组。另选取同期仅进行常规降压治疗未进行叶酸治疗的H型高血压病人30例作为对照组。比较各组病人叶酸治疗前后血压及血浆Hcy水平变化情况。
      结果基因型检测结果显示，观察组102例病人中TT组50例（49.02%），CT组28例（27.45%），CC组24例（23.53%）。对照组基因分型中TT型13例（43.33%），CT型10例（33.33%），CC型7例（23.33%）。治疗前，CC组、CT组收缩压（SBP）均明显高于TT组和对照组（P < 0.01），各组病人舒张压（DBP）间差异无统计学意义（P>0.05）；治疗后，对照组和观察组各组病人SBP、DBP均较治疗前下降（P < 0.05），CC组、CT组SBP下降幅度均明显大于TT组和对照组（P < 0.01），观察组各组DBP下降幅度均大于对照组（P < 0.05），CC组DBP下降幅度亦大于TT组（P < 0.05）。治疗前，TT组血浆Hcy水平均明显高于CT组、CC组和对照组（P < 0.01），CT组与CC组血浆Hcy水平差异无统计学意义（P>0.05）；治疗后，各组Hcy水平间差异无统计学意义（P>0.05），观察组各组和对照组病人血浆Hcy水平均较治疗前明显降低（P < 0.01），TT组Hcy水平下降幅度均大于CT组、CC组和对照组（P < 0.01）。
      结论不同基因型的H型高血压病人血压及血浆Hcy水平存在一定差异，在常规降压药物治疗的同时补充叶酸，有助于进一步改善血压和血浆Hcy水平。

       

      Abstract:
      ObjectiveTo analyze the blood pressure and plasma homocysteine(Hcy) levels in patients with different genotypes of H-type hypertension, and effects of folic acid supplementation on it.
      MethodsOne hundred and two H-type hypertension patients treated with routine antihypertension and folic acid therapy(treatment group) were subdivided into the TT group, CT group and CC group according to the genotypes.At the same time, 30 H-type hypertension patients treated with routine antihypertension and without folic acid were set as the control group.The blood pressure and plasma Hcy levels were compared among these groups before and after folic acid treatment.
      ResultsThe genotype test in treatment group showed that there were 50 cases(49.02%) in TT group, 28 cases(27.45%) in CT group and 24 cases (23.53%) in CC group.In the control group, 13 cases were TT type(43.33%), 10 cases were CT type(33.33%), and 7 cases were CC type(23.33%).Before treatment, the systolic blood pressure(SBP) level in CC group was significantly higher than that in TT group and control group(P < 0.01), but there was no statistical significance in the levels of diastolic blood pressure(DBP) among all groups(P>0.05). After treatment, the levels of SBP and DBP in treatment group and control group decreased compared with before treatment(P < 0.05), the decreasing degrees of SBP in CC group and CT group were significantly greater than those in TT group and control group, the decreasing degree of DBP level in observation group was greater than that in control group(P < 0.05), and the decreasing degree of DBP level in CC group was greater than that in TT group(P < 0.05).Before treatment, the plasma level of Hcy in TT group was higher than that in CT group, CC group and control group(P < 0.01), and the difference of the serum level of Hcy between CT group and CC group was not statistically significant(P>0.05).After treatment, there was no statistical significance in the level of Hcy among all groups(P>0.05), the levels of Hcy in observation group and control group significantly decreased compared with before treatment(P < 0.01), and the decreasing degree of the level of Hcy in TT group was greater than that in CT group, CC group and control group(P < 0.01).
      ConclusionsThere are some differences in blood pressure and plasma Hcy levels in patients with different genotypes of H-type hypertension.The folic acid supplementation combined with conventional antihypertensive drug therapy can further improve the blood pressure and plasma Hcy levels.

       

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