摘要
目的分析H型高血压在社区卫生服务中心的发病特点及小剂量叶酸在H型高血压中的治疗价值。方法对2012年4月至2013年4月海淀区西三旗社区卫生服务中心收治的348例H型高血压患者进行观察,采用随机数字表法将患者分为降压药组和联合叶酸组,每组各174例,降压药组患者采取贝那普利治疗,10 mg/d,口服;联合叶酸组在降压药组的基础上给予叶酸治疗,0.4 mg/d,口服;同时选取在卫生服务中心进行治疗的未合并高同型半胱氨酸血症的原发性高血压患者326例;观察两组患者的临床特点、知晓率、治疗率,比较两组治疗效果及预后。结果原发性高血压患者与H型高血压患者比较的男性发病率(42.0%vs 60.9%)、年龄[(57.3±8.9)岁vs(62.2±8.3)岁]、心率[(72.4±1.7)次/min vs(76.3±2.0)次/min]、舒张压[(81.3±3.5)mm Hg vs(86.2±3.2)mm Hg]、肌酐[(63.9±14.9)μmol/L vs(69.3±15.9)μmol/L]、尿酸[(291.2±72.4)μmol/L vs(313.4±71.6)μmol/L]均显著低于H型高血压患者,脉压[(60.2±13.7)mm Hg vs(56.7±15.2)mm Hg]、知晓率(48.8%vs 23.3%)、治疗率(30.1%vs 12.9%)显著高于H型高血压患者。治疗后联合叶酸组与降压药组比较,收缩压[(121.3±10.3)mm Hg vs(125.4±11.3)mm Hg]、舒张压[(82.4±2.9)mm Hg vs(84.2±2.7)mm Hg]、血中同型半胱氨酸水平[(10.1±1.9)μmol/L vs(12.9±0.8)μmol/L]、三年内脑卒中发生率(8.1%vs 14.4%)均显著低于降压药组(P<0.05)。结论 H型高血压患者高发于中老年男性患者,对于心血管以及肾脏均有严重影响,小剂量叶酸可以有效治疗H型高血压,改善预后。
ObjectiveTo analyze the clinical characteristic of type H hypertension and clinical value of small dose of folic acid in the treatment of type H hypertension.MethodsA total of 348 type H hypertension patients in Haidian District Xisanqi Community Health Service Center from Apr.2012 to Apr.2013 were selected for this study,they were divided into two groups according to random number table,the group of combination with folic acid and the group of hypotensive drugs,each of 174 cases.The group of hypotensive drugs was treated with benazepril,10 mg/d,orally; the group of combination with folic acid was treated with folic acid treatment,0.4 mg/d,orally based on the hypotensive drugs.In the same time,326 primary hypertension patients without ectopic high level of homocysteine were selected,and the clinical characteristics,awareness rate,treatment rate,the effects of the therapy and prognosis were observed.ResultsIn the patients with primary hypertension compared with Type H hypertension,morbidity of male was （42.0% vs 60.9%）,age was [（57.3±8.9）y vs（62.2±8.3）y],heart rate was[（72.4±1.7） times/min vs （76.3±2.0）]times/min],diastolic blood pressure was[ （81.3±3.5） mm Hg vs （86.2±3.2）mm Hg],creatinine was[（63.9±14.9）μmol/L vs （69.3±15.9）μmol/L],uric acid was[（291.2±72.4）μmol/L vs （313.4±71.6）μmol/L],the former were lower than the latter;while pulse pressure was [（60.2±13.7）mmHg vs （56.7±15.2）mmHg],and awareness rate was （48.8% vs 23.3%）,and treatment rate was （30.1% vs 12.9%）,the former significantly higher than the latter（P〈0.05）.After treatment the group of combination with folic acid comparing with the group of hypotensive drugs,the systolic pressure was[（121.3±10.3） mm Hg vs （125.4±11.3） mm Hg],diastolic blood pressure was[（82.4±2.9）mm Hg vs （84.2±2.7）mm Hg],homocysteine was [（10.1±1.9）μmol/L vs （12.9±0.8）μmol/L],the morbidity of stroke within three years was （8.1% vs 14.4%）,the former significantly lower
出处
《医学综述》
2014年第4期766-768,共3页
Medical Recapitulate
关键词
H型高血压
发病特点
叶酸
Type H hypertension
Clinical characteristics
Folic acid
