MTHFR基因多态性对老年H型高血压患者同型半胱氨酸水平的影响

摘要

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 influence of the gene polymorphism of methylenetetrahydrofolate reductase(MTHFR) on plasma level of homocysteine(Hcy) in elderly patients with H type hypertension.Methods The MTHFR genotypes were detected with MTHFR 677C/T test box and PCR technique in 122 elderly patients with H type hypertension.On the basis of routine treatments,all patients were treated with folic acid 5 mg/d orally for 12 weeks.Plasma levels of Hcy and blood pressure were measured before and after treatment.Results Of 122 cases,26 cases were with MTHFR CC type,51 cases with CT type and 45 cases with TT type.The proportion of TT type in the patients with stage 3 hypertension was higher than that of CC type and CT type(P<0.05).Plasma level of Hcy and systolic blood pressure were higher in TT type than those in CC type and CT type before treatment(P<0.05).Plasma level of Hcy and systolic blood pressure were lower after treatment than those before in three types(P<0.05),which were higher in TT type than those in CC type and CT type after treatment(P<0.05).Plasma level of Hcy was higher in TT type than that of CC type and CT type before and after treatment in the patients with stage 3 hypertension(P<0.05).Conclusion In the elderly patients with H type hypertension,the distribution frequency of MTHFR TT type and plasma Hcy level are higher than those of MTHFR CC type and CT type.The efficacy of oral folic acid is effective in reducing plasma Hcy in the elderly patients with H type hypertension,which is weaker in those with TT type than those with CC type and CT type.