【摘要】 目的 探讨叶酸治疗青年原发性高血压的临床效果研究。方法 择取2022年3月至2023年2月在东莞市人民医院急诊科就诊的青年原发性高血压患者作为研究对象，共纳入200例，按照抽签法划分为对照组和干预组，每组各100例。对照组实施常规治疗，干预组在对照组基础上加用叶酸治疗。两组治疗后血生化检验指标、治疗前后的颈动脉内中膜厚度与颈动脉粥样硬化病变体积、治疗后的舒张末期室间隔厚度、左室舒张末期内径、舒张末期左心室后壁厚度、不同亚甲基四氢叶酸还原酶（MTHFR）、甲硫氨酸合成酶还原酶（MTRR）基因型青年原发性高血压患者治疗前后的血压水平情况进行比较。结果 治疗后，干预组各项血生化检验指标均优于对照组，差异有统计学意义（P <0.05）。治疗前后，两组颈动脉内中膜厚度与颈动脉粥样硬化病变体积比较，差异无统计学意义（P> 0.05）。干预组治疗后的舒张末期室间隔厚度、左室舒张末期内径、舒张末期左心室后壁厚度情况均优于对照组，差异有统计学意义（P <0.05）。MTHFR野生型（MTHFR 667CC型）、MTHFR杂合突变型（MTHFR 667CT型）、MTHFR纯合突变型（MTHFR 667TT型）、MTRR 66点位（MTRR 66G）型、MTRR基因型（MTRR A66G型）基因型青年原发性高血压患者治疗前的舒张压与收缩压比较，差异无统计学意义（P> 0.05）；治疗后五类基因型患者血压水平均低于治疗前，差异有统计学意义（P <0.05）;MTHFR 667CC型与MTRR 66G型治疗后的舒张压与收缩压均低于MTHFR667CT型、MTHFR 667TT型与MTRR A66G型，差异有统计学意义（P <0.05）；而MTHFR 667CC型与MTRR 66G型治疗后的舒张压与收缩压比较，差异无统计学意义（P> 0.05）。结论 叶酸治疗青年原发性高血压的临床价值较高，能更好的控制患者血压，同时稳定地项血生化检验指标，有利于改善颈动脉内中膜厚度与颈动脉粥样硬化病变情况，对心脑靶向损害保护程度高，值得推广。更多还原

【Abstract】 Objective To study the clinical effect of folic acid in the treatment of primary hypertension in young people. Methods A total of 200 young patients with primary hypertension who were admitted to the Emergency Department of Dongguan People’s Hospital from March 2022 to February 2023 were selected as the research object and divided into the control group and the intervention group according to the lottery method,with 100 patients in each group. The control group was treated with routine therapy, while the intervention group was treated with folic acid on the basis of routine therapy. The blood biochemical indexes after treatment, carotid intima-media thickness and carotid atherosclerotic lesion volume before and after treatment, end-diastolic ventricular septal thickness, left ventricular end-diastolic dimension and left ventricular end-diastolic posterior wall thickness after treatment, and blood pressure levels of young patients with different methylenetetrahydrofolate reductase(MTHFR) and methionine synthase reductase(MTRR) genotypes before and after treatment were compared between the two groups. Results After treatment, all blood biochemical indexes in the intervention group were better than those in the control group, with the difference was statistically significant(P < 0.05). Before and after treatment, there was no difference between the two groups in carotid intima-media thickness and carotid atherosclerotic lesion volume(P > 0.05). After treatment, the end-diastolic ventricular septal thickness, left ventricular end-diastolic dimension and left ventricular end-diastolic posterior wall thickness of the intervenient group were better than those of the control group, with the difference was statistically significant(P < 0.05). There was no significant difference between diastolic blood pressure and systolic blood pressure in young patients with primary hypertension of MTHFR wild type(MTHFR 667CC type), MTHFR heterozygous mutant type(MTHFR 667CT type), MTHFR homozygous mutant type(MTHFR 667T type), MTRR 66-locus(MTRR 66G) type and MTRR genotype(MTRR A66G type) genotypes before treatment(P > 0.05). After treatment, the blood pressure levels of patients with five genotypes were lower than those before treatment, and the difference was statistically significant(P < 0.05). The diastolic blood pressure and systolic blood pressure of MTHFR 667CC and MTRR 66G after treatment were lower than those of MTHFR 667CT, MTHFR 667TT and MTRR A66G, and the difference was statistically significant(P < 0.05). However, there was no significant difference in diastolic blood pressure and systolic blood pressure between MTHFR 667CC and MTRR 66G after treatment(P > 0.05). Conclusion Folic acid has a high clinical value in the treatment of primary hypertension in young people. It can control the patients’ blood pressure and stabilize various blood biochemical indexes, which is beneficial to improve the carotid intima-media thickness and carotid atherosclerosis, providing high degree of protection against the targeted damage of heart and brain. Therefore, it is worth popularizing.更多还原