2020 年第 7 期 第 15 卷

叶酸联合维生素B12对H型高血压患者临床治疗效果及血清N末端B型脑钠肽前体和血栓素A2水平的影响

The effect of folic acid and vitamin B12 on type H hypertension and the level of serum N-terminal pro-brain natriuretic peptide and thromboxane A2

作者：费龙马浩然

英文作者：Fei Long Ma Haoran

单位：武汉市第一医院药学部430022

英文单位：Department of Pharmacy Wuhan First Hospital Wuhan 430022 China

关键词：高血压；高同型半胱氨酸血症；叶酸；血栓素A2；颈动脉斑块

英文关键词：Hypertension；Hyperhomocysteinemia；Folicacid；ThromboxaneA2；Carotidarteryplaque

• 摘要：

• 目的探讨叶酸联合维生素B12对H型高血压患者临床治疗效果及血清N末端B型脑钠肽前体（NT-proBNP）和血栓素A2水平的影响。方法回顾性选取2014年5月至2016年12月武汉市第一医院收治的H型高血压患者86例，根据治疗方法不同分为对照组和观察组，各43例。对照组患者采用常规治疗，观察组在常规治疗的同时联合叶酸和维生素B12治疗，共治疗4周，比较2组患者的治疗效果、颈动脉斑块积分及NT-proBNP、同型半胱氨酸、内皮素1、一氧化氮、血栓素A2水平和踝臂指数的变化情况。结果治疗后2组收缩压及舒张压均较治疗前下降，且观察组低于对照组，差异均有统计学意义（均P<0.05）。治疗后1、2年观察组颈动脉斑块积分低于治疗前和对照组，差异均有统计学意义（均P<0.05）。治疗后观察组NT-proBNP、同型半胱氨酸、内皮素1、血栓素A2水平均低于对照组，一氧化氮水平高于对照组［（1 701±120）ng/L比（3 025±154）ng/L、（17.2±2.0）μmol/L比（19.9±2.1）μmol/L、（103±8）ng/L比（185±10）ng/L、（197±20）ng/L比（243±22）ng/L、（135±13）mmol/L比（82±11）mmol/L］，差异均有统计学意义（均P<0.05）。治疗后观察组踝臂指数高于对照组，差异有统计学意义（P<0.05）。结论叶酸联合维生素B12辅助治疗H型高血压可有效降低患者血压和NT-proBNP、Hcy水平，改善血管内皮功能，减轻动脉粥样硬化程度。

• ObjectiveTo investigate the effect of folic acid and vitamin B12 on type H hypertension and the level of serum N-terminal pro-brain natriuretic peptide(NT-proBNP) and thromboxane A2. Methods Totally 86 patients with type H hypertension from May 2014 to December 2016 admitted to Wuhan First Hospital were enrolled. They were divided into control group and observation group according  to different treatment methods , with 43 cases in each group. The control group was treated with conventional treatment； and the observation group were treated by routine treatment combined with folic acid and vitamin B12， both groups were treated for 4 weeks. The therapeutic effect, carotid plaque score and NT-proBNP, homocysteine, endothelin 1, nitric oxide, thromboxane A2 levels and changes of ankle brachial index were compared between the two groups. Results  After treatment, the systolic and diastolic blood pressures were lower than those before treatment； and the blood pressures in observation group were lower than those in control group； the difference were statistically significant(all P<0.05). After 1 and 2 years of treatment, the scores of carotid plaque in the observation group were lower than those before treatment and in the control group； the difference was statistically significant(all P<0.05). After treatment, the levels of NT-proBNP, homocysteine, endothelin 1 and thromboxane A2 in the observation group were lower， the level of nitric oxide in the observation group was higher than those in the control group［（1 701±120）ng/L vs （3 025±154）ng/L, （17.2±2.0）μmol/L vs （19.9±2.1）μmol/L, （103±8）ng/L vs （185±10）ng/L, （197±20）ng/L vs （243±22）ng/L, （135±13）mmol/L vs （82±11）mmol/L］(all P<0.05). After treatment, the ankle brachial index in observation group was higher than that in control group(P<0.05). Conclusion Folic acid combined with vitamin B12 in the adjuvant treatment of type H hypertension can effectively reduce blood prese, NT-proBNP and homocysteine level, and it can also improve vascular endothelial function and reduce the degree of atherosclerosis.