老年H型高血压发病率及高同型半胱氨酸血症的治疗研究(1)
摘要：目的 了解保定地区老年人高同型半胱氨酸血症(HHcy)伴原发性高血压患者发病情况及叶酸治疗的合理剂量。方法 2016～2017年就诊于河北省保定市老年病医院老年人原发性高血压392例，在患者选用适合自己病情的不同降压药的情况下，依据随机抽样法将其分成两组，检测30 d后的血浆同型半胱氨酸(Hcy)含量、收缩压、舒张压、不良反应发生率等。结果 按Hcy≥15 μmol/L的标准60岁以上老人312例发病率为79.59%；第一组口服叶酸5 mg/d；第二组口服叶酸2.5 mg/d。两组均服药30 d，口服叶酸前后抽血监测Hcy值。第一组治疗后较治疗前Hcy下降40.24%，第二组下降39.13%，经统计学处理P>0.05，无明显统计学差异。结论 选择适合自己不同降压药治疗并使血压降至正常水平情况下，长期口服叶酸 2.5 mg/d是治疗HHcy的最佳方法。
关键词：老年人；H型高血压；同型半胱氨酸；叶酸
中图分类号：R544.1 文献标识码：A 文章编号：1006-1959(2017)21-0031-03
, 百拇医药
Study on the Treatment of Hypertension in Elderly Type H and Hyperhomocysteinemia
XU Shu-qian1，YANG Gang1，BAN Wei1，FENG Shu-ming2，CAO Yan-xia2，LI Zhen-lu2
(1.Department of Internal Medicine，Geriatrics Hospital，Baoding 071000，Hebei，China；
2.Department of Internal Medicine，The 252 Hospital of PLA，Baoding 071000，Hebei，China)
Abstract：Objective To investigate the elderly in Baoding area of hyperhomocysteinemia(HHcy)with the appropriate dose of primary cases and folic acid treatment of essential hypertension.Methods 2016～2017 visits to the elderly in Hebei city of Baoding province geriatric hospital in 392 cases of primary hypertension，in patients selected for their condition under the condition of different antihypertensive drugs，according to randomly divided into two groups，30 d after the detection of plasma homocysteine(Hcy)levels，the systolic blood pressure，diastolic blood pressure，the incidence of adverse reactions.Results According to 60 years of age or older Hcy of more than 15 μmol/L standard 312 cases the incidence rate was 79.59%；the first group of oral folic acid 5 mg/d；group second oral folic acid 2.5 mg/d.Both groups were given 30 d of oral administration of folic acid before and after folic acid monitoring Hcy value.The first group of treatment after treatment than Hcy decreased by 40.24%，the second group decreased by 39.13%，by statistical treatment P>0.05，no significant statistical differences.Conclusion Long-term oral folic acid 2.5 mg/d is the best method for the treatment of HHcy in the case of selection of different antihypertensive drugs for treatment and lowering blood pressure to normal levels.
, 百拇医药
Key words：Elderly；H-type hypertension；Homocysteine；Folic acid
1 資料与方法
1.1一般资料
本研究以2016年1月～2017年1月就诊于河北省保定市老年病医院的老年人原发性高血压392例为研究对象，采取随机抽样法。医护人员对就诊患者详细询问病史、家族史、生活方式及有无遗传病史，并抽血查同型半胱氨酸(Hcy)、血总胆固醇(TC)、甘油三酯(TG)、血糖(FBG)、尿微量蛋白(尿β2-MG)、尿素氮(BUN)、血肌酐(SCr)、肝功能等。排除继发性高血压并除外合并有肝肾及免疫性疾病等。确诊老年原发性高血压患者392例。按照WHO将HHCY的界线标准定为Hcy≥15 μmol/L的规定，确诊老年人H型高血压为312例，占老年原发性高血压人数的79.59%，高于北京地区60岁以上老年H型高血压50.2%的报导。, 百拇医药(许舒千 杨刚 班伟 冯树明 曹艳霞 李振录)
关键词：老年人；H型高血压；同型半胱氨酸；叶酸
中图分类号：R544.1 文献标识码：A 文章编号：1006-1959(2017)21-0031-03
, 百拇医药
Study on the Treatment of Hypertension in Elderly Type H and Hyperhomocysteinemia
XU Shu-qian1，YANG Gang1，BAN Wei1，FENG Shu-ming2，CAO Yan-xia2，LI Zhen-lu2
(1.Department of Internal Medicine，Geriatrics Hospital，Baoding 071000，Hebei，China；
2.Department of Internal Medicine，The 252 Hospital of PLA，Baoding 071000，Hebei，China)
Abstract：Objective To investigate the elderly in Baoding area of hyperhomocysteinemia(HHcy)with the appropriate dose of primary cases and folic acid treatment of essential hypertension.Methods 2016～2017 visits to the elderly in Hebei city of Baoding province geriatric hospital in 392 cases of primary hypertension，in patients selected for their condition under the condition of different antihypertensive drugs，according to randomly divided into two groups，30 d after the detection of plasma homocysteine(Hcy)levels，the systolic blood pressure，diastolic blood pressure，the incidence of adverse reactions.Results According to 60 years of age or older Hcy of more than 15 μmol/L standard 312 cases the incidence rate was 79.59%；the first group of oral folic acid 5 mg/d；group second oral folic acid 2.5 mg/d.Both groups were given 30 d of oral administration of folic acid before and after folic acid monitoring Hcy value.The first group of treatment after treatment than Hcy decreased by 40.24%，the second group decreased by 39.13%，by statistical treatment P>0.05，no significant statistical differences.Conclusion Long-term oral folic acid 2.5 mg/d is the best method for the treatment of HHcy in the case of selection of different antihypertensive drugs for treatment and lowering blood pressure to normal levels.
, 百拇医药
Key words：Elderly；H-type hypertension；Homocysteine；Folic acid
1 資料与方法
1.1一般资料
本研究以2016年1月～2017年1月就诊于河北省保定市老年病医院的老年人原发性高血压392例为研究对象，采取随机抽样法。医护人员对就诊患者详细询问病史、家族史、生活方式及有无遗传病史，并抽血查同型半胱氨酸(Hcy)、血总胆固醇(TC)、甘油三酯(TG)、血糖(FBG)、尿微量蛋白(尿β2-MG)、尿素氮(BUN)、血肌酐(SCr)、肝功能等。排除继发性高血压并除外合并有肝肾及免疫性疾病等。确诊老年原发性高血压患者392例。按照WHO将HHCY的界线标准定为Hcy≥15 μmol/L的规定，确诊老年人H型高血压为312例，占老年原发性高血压人数的79.59%，高于北京地区60岁以上老年H型高血压50.2%的报导。, 百拇医药(许舒千 杨刚 班伟 冯树明 曹艳霞 李振录)
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