Effect Of Folic Acid Combined With Mecobalamin On Blood Homocysteine Level And Carotid Intima Media Thickness In Patients With Type H Hypertension

Objective:To investigate the effect of folic acid combined with mecobalamin on blood homocysteine level and carotid intima media thickness in patients with type H hypertension.Methods:In strict accordance with the inclusion standard,exclusion standard and shedding standard,atotal of 120patients withtypeH hypertension who were admitted to our hospital from march to May 2017 were selected.Patients’age,gender,smoking history,drinking history,blood lipid(LDL),body mass index,blood pressure and other basic data were recorded.All patients received health education,diet control,weight control,smoking and drinking cessation,and the same type of antihypertensive drugs before the trial.120 patients were randomly divided into 3 groups,40cases of control group(group A)and control group given conventional antihypertensive drug treatment,40 cases in the experimental group B patients in the control group on the basis of given folic acid(0.8 mg/d)treatment,the experimental group C on the basis of 40 patients in the control group while giving folic acid(0.8 mg/d)joint A cobalt amine(0.5 mg/d)treatment,three groups of patients were treated for 12 months.Blood Hcy level and CIMT values were determined before treatment,3 months after treatment,6 months after treatment and 12 months after treatment,respectively.SPSS18.0 statistical software package was used to manage and analyze the data.The blood Hcy level and CIMT presented a skewed distribution,which was statistically analyzed by logarithmic transformation.Counting data was represented by rate(%),and x~2 test was used.Measurement data to mean±standard deviation(?x±s)said,compared with single factor analysis of variance between groups(LSDt test).Pearson correlation analysis was used to analyze the correlation between blood Hcylevel and CIMT.P<0.05 was considered statistically significant.Results:1.There were no statistically significant differences in age,gender,body mass index(BMI),smoking history,drinking history,low density lipoprotein(ldl-c)level or blood pressure among the three groups(P>0.05).2.Pearson correlation analysis was used to analyze the correlation between blood Hcylevel and CIMT,and the results showed that there was a positive correlation between the two(r=0.240,P<0.05).3.Hcy concentration:the concentration of the group A was 20.55±3.47 mu/L,the group B to20.29±3.27 mu/L,and the group C to 20.31±2.93 mu/L.There was no statistically significant difference between the three groups(P>0.05).Three months later,the concentration of group A was20.52±3.53μmol/L,the concentration of group B was13.71±3.46μmol/L,and the concentration of group C was13.70±2.87μmol/L.Compared with the control group,the blood Hcy level decreased,the difference was statistically significant(P=0.000),P=0.992 between group B and group C,there was no statistical difference.At 6months,the concentration of group A was20.11±3.54μmol/L,the concentration of group B was12.17±3.42μmol/L,the concentration of group C was10.51±2.07μmol/L,and the blood Hcy level was further decreased,and the difference between group B and group C was statistically significant(P=0.018).At the 12th month,the concentrations were:19.56±3.42μmol/L in group A,10.62±3.47μmol/L in group B,8.92±1.78μmol/L in group C,blood Hcy level in the treatment group continued to decline compared with that in the 6-month period,and the difference between group B and group C was further enlarged(P=0.012).After 12 months of medication,Hcy in group B decreased by47.66%,while that in group C decreased by 56.08%.Therefore,compared with the single drug administration group,Hcy in the combined drug administration group decreased by 8.42%.4.CIMT values:Before the treatment,group A was1.40±0.30mm,group B was 1.39±0.21mm,and group C was 1.42±0.18mm.There was no statistically significant difference between the three groups(P>0.05).After 3 months of treatment,group A was 1.42±0.28mm,group B was1.33±0.22mm,and group C was 1.35±0.20mm.At 6 months of treatment,the CIMT of group A was 1.45±0.28mm,group B was 1.27±0.21mm,and group C was 1.15±0.14mm.At the 12th month of treatment,the CIMT of group A was1.46±0.28mm,group B was 1.14±0.18mm,and group C was 1.00±0.16mm.The difference between group B and group C widened(P=0.004).After 12months of administration,CIMT decreased by 17.99%in group B and 29.58%in group C,and further decreased by 11.59%in the combined administration group compared with the single administration group.Conclusion:1.Folic acid combined with mecobalamin can effectively reduce the blood homocysteine level in patients with type H hypertension,reduce the thickness of carotid intima and middle layers,so as to slow down the formation of atherosclerotic plaques and prevent the occurrence of ischemic stroke.2.The curative effect of combined administration was better than that of single administration.The Hcy level in the combined treatment group was 8.42%lower than that of the single administration group,while the CIMT value was 11.59%lower.Therefore,the combined drug regimen is worthy of clinical application.