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目的探讨亚甲基四氢叶酸还原酶(MTHFR)基因多态性对老年H型高血压患者同型半胱氨酸(Hcy)水平的影响。方法使用MTHFR 677C/T检测试剂盒和PCR方法检测122例老年H型高血压患者的MTHFR基因型。患者均在常规降压治疗基础上加用叶酸5mg/d口服,治疗前及治疗12周检测Hcy和血压水平。结果 122例中,MTHFR CC型26例,CT型51例,TT型45例;3级高血压患者TT型比例高于CC型及CT型(P<0.05)。TT型患者治疗前血浆Hcy、收缩压高于CC型和CT型(P<0.05),治疗12周,CC型、CT型和TT型患者血浆Hcy和收缩压均较治疗前下降(P<0.05),TT型患者血浆Hcy和收缩压仍高于CC型和CT型(P<0.05)。3级高血压患者中,治疗前及治疗12周TT型Hcy水平均高于CC型和CT型(P<0.05)。结论在老年H型高血压患者中,MTHFR TT型分布频率较高,其血浆Hcy水平和血压高于CC型和CT型。口服叶酸可以有效降低老年H型高血压患者血浆Hcy水平,TT型血浆Hcy降低效果不及CC型及CT型。
Objective To investigate the effect of methylenetetrahydrofolate reductase (MTHFR) gene polymorphism on homocysteine (Hcy) level in elderly patients with Hypertension. Methods The MTHFR genotypes of 122 elderly Hypertensive patients were detected by MTHFR 677C / T detection kit and PCR. Patients were treated with folic acid 5mg / d on the basis of conventional antihypertensive therapy, Hcy and blood pressure were measured before treatment and 12 weeks after treatment. Results Of the 122 cases, 26 cases were MTHFR CC, 51 cases were CT and 45 cases were TT. The proportion of TT in grade 3 hypertension was higher than that in CC and CT (P <0.05). The plasma Hcy and systolic blood pressure of patients with TT before treatment were higher than those of patients with CC and CT (P <0.05). After 12 weeks of treatment, the plasma Hcy and systolic blood pressure in patients with CC, CT and TT were significantly lower than those before treatment (P <0.05) ), Plasma Hcy and systolic blood pressure were still higher in patients with TT than CC and CT (P <0.05). Among grade 3 hypertensive patients, the levels of TT Hcy before and 12 weeks after treatment were higher than those of CC and CT (P <0.05). Conclusion In elderly Hypertension patients, MTHFR TT type has a higher distribution frequency, higher plasma Hcy level and higher blood pressure than those of CC type and CT type. Oral folic acid can effectively reduce plasma Hcy levels in elderly patients with Hypertension, TT type plasma Hcy decreased less effective than CC and CT type.