摘要
目的研究叶酸及常规治疗H型高血压患者后,血浆同型半胱氨酸（Hcy）、高敏C-反应蛋白（hs-CRP）水平及心血管事件的变化。方法入选H型老年高血压患者120例,随机分为干预组和对照组,每组60例。对照组采用常规治疗,干预组在对照组基础上加用叶酸,检测、记录2组血浆Hcy、hs-CRP水平及心血管事件,采用受试者工作曲线（ROC）等方法进行分析。结果治疗12周后,干预组患者血浆Hcy及hs-CRP均明显降低,降低幅度明显高于对照组（P〈0.05）;干预组心血管事件的发生率明显低于对照组（P〈0.05）;ROC曲线下的面积差异有统计学意义（0.7454,0.6326~0.8583,P=0.0007）,当血浆Hcy水平=24.83μmol/L时,灵敏度为69.31%,特异度为78.95%。结论 H型患者经叶酸＋降压治疗,可明显降低血浆Hcy水平、血浆炎性因子和心血管事件的发生;血浆Hcy水平对于心血管事件的发生具有较高的预测价值,应监测血浆Hcy水平以积极预防心血管事件。
Objective To investigate the effect of folic acid supplementation on the levels of plasma homocysteine, high-sensitivity C-reactive protein （hs-CRP） and cadiovascular events in elderly patients with type H hypertension in order to provide scientific basis for the treatment of the disease. Methods One hundred and twenty elderly patients with type H hypertension were randomly divided into intervention group （ n = 60） and control group （ n = 60）. The patients in control group were treated by routine therapy, however, the patients in intervention group, on the basis of conventional antihypertensive treatment, were treated by folic acid. The levels of plasma homocysteine （ Hcy）, inflammatory factor - hs-CRP and incidence of cardiovascular events were detected and observed, finally, the results were analyzed by means of receiver operating curve （ROC）. Results After 12 -week treatment, the levels of plasma Hcy and hs-CRP in intervention group were significantly decreased,as compared with those in control group （ P 〈 0. 05 ）. The incidence （8.33%） of cardiovascular events in intervention group was significantly lower than that （23.33%） in control group （ P 〈0.05 ）. There was significant difference in the area under ROC curve between two groups （0. 7454,0. 6326 -0. 8583, P 〈 0.01 ）, when plasma levels of Hcy was equal to 24. 831xmol/L, the sensitivity was 69.31% and specificity was 78.95%. Conclusion Folic acid combined with antihypertensive therapy can significantly reduce plasma levels of Hey and plasma inflammatory factors, and can decrease the incidence of cardiovascular events in elderly patients with type H hypertension, moreover, plasma levels of Hcy are of important predictive value for predicting the incidence of cardiovascular events, thus, we should pay much attention to monitoring plasma levels of Hey in order to actively prevent cardiovascular events.
出处
《河北医药》
CAS
2016年第7期968-971,共4页
Hebei Medical Journal
基金
上海市浦东科技发展基金创新资金资助(编号:PKJ2012-Y38)
关键词
H型高血压
叶酸
心血管事件
预测
type H hypertension
folate
cardiovascular events
prediction
