【摘要】 目的 探讨佛山地区MTHFR基因多态性的高血压患者应用药物干预后对同型半胱氨酸（Hcy）水平及心脑血管事件的影响。方法 选择2013年4月至2015年9月于佛山市第二人民医院收治的H型高血压患者249例，按治疗方式不同分为治疗组79例和对照组170例。对照组未开展任何治疗，治疗组则应用药物马来酸依那普利叶酸片治疗。定期复查Hcy水平并登记心脑血管事件率。结果 治疗组药物干预后Hcy水平低于干预前，且CT型、CC型患者药物干预后Hcy水平均低于干预前（P<0.05）。对照组药物干预后Hcy水平低于干预前，且CT型、CC型患者药物干预后Hcy水平均低于干预前（P<0.05）。治疗组与对照组脑梗死以及死亡发生率差异无统计学意义（P>0.05）。治疗组短暂性脑缺血发作（TIA）、冠心病及心绞痛的发生率均明显低于对照组（P<0.05）。结论 H型高血压患者接受药物（马来酸依那普利叶酸片）干预后对Hcy水平明显下降，不会增加心脑血管事件发生风险。更多还原

【Abstract】 Objective To investigate the influence of medicinal intervention on level of homocysteine(Hcy and incidence rate of cardiovascular and cerebrovascular events in hypertensive patients with methylenetrahydrofolate reductase(MTHFR) gene polymorphism in Foshan area. Methods The patients with H-type hypertension(n=249) were chosen from the Second People’s Hospital of Foshan City from Apr. 2013 to Sept. 2015. All patients were divided,according to treatment methods, into treatment group(n=79) and control group(n=170). The control group was not given any treatment, and treatment group was treated with enalapril maleate folic acid tablets. The level of Hcy was reexamined periodically and incidence rate of cardiovascular and cerebrovascular events was recorded. Results The level of Hcy was lower after medicinal intervention than before in treatment group, and was lower in patients with CT genotype and CC genotype after medicinal intervention than before(P<0.05). The level of Hcy was lower after medicinal intervention than before in control group, and was lower in patients with CT genotype and CC genotype after medicinal intervention than before(P<0.05). The difference in incidence rates of cerebral infarction and death had no statistical significance between treatment group and control group(P>0.05). The incidence rates of transient ischemic attack(TIA), coronary heart disease and angina pectoris were significantly lower in treatment group than those in control group(P<0.05). Conclusion The level of Hcy decreases significantly, and risks of cardiovascular and cerebrovascular events are not increased in patients with H-type hypertension after intervention with medicinal(enalapril maleate folic acid tablets).更多还原