氨氯地平联合依那普利/叶酸对H型高血压的疗效及其与EL和APN的关系  

Effect of amlodipine combined with enalapril maleate/folic acid on control of blood pressure and its association with EL and APN in patients with H-type hypertension

作　　者：李庆辉[1] 谭碧峰 杨天伦[3] 彭再如[1] 刘存根[1] 马海明[4] 曾朝辉[5] 

机构地区：[1]湖南农业大学医院心内科,湖南长沙410128 [2]湖南医药学院第一附属医院心内科,湖南怀化418000 [3]中南大学湘雅医院心内科,湖南长沙410008 [4]湖南农业大学动物科学技术学院,湖南长沙410128 [5]湖南农业大学科研处,湖南长沙410128

出　　处：《中国临床研究》2016年第5期594-597,共4页Chinese Journal of Clinical Research

基　　金：湖南省科技厅社会发展支撑计划项目资助(2013SK3159)

摘　　要：目的观察氨氯地平联合马来酸依那普利/叶酸片(依叶片)对H型高血压的疗效,探讨H型高血压患者血清内皮脂肪酶(EL)和脂联素(APN)水平变化与疗效的关系。方法将90例H型高血压患者随机分成氨氯地平组30例,依叶组30例,氨氯地平+依叶组30例,分别予以口服氨氯地平片、依叶片、氨氯地平片+依叶片治疗6个月,另选择30例健康人作为对照组。观察用药前后各组患者的血压,血清EL、APN及血浆同型半胱氨酸(Hcy)水平。结果 H型高血压患者治疗前血清EL水平显著高于对照组,血清APN水平显著低于对照组,差异均有统计学意义(P均<0.01);治疗6个月后,氨氯地平组、依叶组和氨氯地平+依叶组患者血压均得到有效控制,血清EL水平显著降低,血清APN水平显著升高(P均<0.01),但氨氯地平+依叶组均优于氨氯地平组和依叶组(P均<0.05)。结论氨氯地平、依叶片及氨氯地平联合依叶片均能有效控制血压,降低血清EL含量和升高APN含量,但氨氯地平+依叶片效果更明显,提示EL和APN参与了H型高血压的发生、发展,可以作为判断H型高血压严重程度的指标。Objective To observe the efficacy of amlodipine combined with enalapril maleate/folic acid tablets（ enalapril/folic acid tablets） on controlling blood pressure in the treatment of H-type hypertension patients and explore the relationship between the efficacy and the changes of serum endothelial lipase（ EL） and adiponectin（ APN）. Methods Ninety H-type hypertension patients were randomly divided into amlodipine treatment group,enalapril/folic acid treatment group and amlodipine plus enalapril/folic acid treatment group（ n = 30 each）,and amlodipine tablets,enalapril/folic acid tablets and amlodipine tablets plus enalapril/folic acid tablets were respectively given for six months. Thirty healthy subjects were selected as control group. The levels of blood pressure,the serum EL,APN and plasma homocysteine（ Hcy） levels before and after medication were observed. Results Before treatment,compared with control group,the serum EL level significantly increased,and serum APN level decreased in H-type hypertension patients（ all P 0. 01）. After treatment,hypertension level was effectively controlled in all patients of H-type hypertension of three groups. Compared with pre-treatment,serum EL level significantly decreased,and serum APN level significantly increased in amlodipine group,enalapril/folic acid group and amlodipine plus enalapril/folic acid group（ all P 0. 01）,while these effects in amlodipine plus enalapril/folic acid group were all significant superior to amlodipine group and enalapril/folic acid group（ all P 0. 05）. Conclusions The blood pressure in H-type hypertension patients can effectively be controlled with amlodipine,enalapril/folic acid and amlodipine combined with enalapril/folic acid. After treatment,the level of serum EL decreased,and the level of serum APN increased,but the effects of amlodipine combined with enalapril/folic acid are better. The EL and APN might be involved in the occurrence and development of H-type hypertension and may be served as the indexes for judgin

关 键 词：H型高血压 内皮脂肪酶 脂联素 马来酸依那普利/叶酸片 氨氯地平片 

分 类 号：R544.1[医药卫生—心血管疾病]