依那普利联用叶酸治疗H型高血压的临床疗效及对血管内皮功能的影响  

Clinical efficacy and enalapril combined with folic acid in the treatment of H-type hypertension and its influence on vascular endothelial function

作　　者：陈慧[1] 徐群威 

机构地区：[1]台州市中西医结合医院心内科,浙江温岭317523

出　　处：《中华全科医学》2017年第5期805-807,867,共4页Chinese Journal of General Practice

摘　　要：目的分析与探讨采用依那普利联合叶酸治疗H型高血压患者的疗效,并研究其对患者血管内皮功能的影响。方法选取2014年10月—2015年10月收治的170例H型高血压患者,按照随机数字法随机分为观察组和对照组,每组85例,对照组给予马来酸依那普利片进行治疗,观察组在对照组基础上给予叶酸片进行治疗,比较2组治疗前及治疗24周后动态血压、同型半胱氨酸(Hcy)、血浆可溶性细胞间黏附分子1(sICAM-1)、颈动脉内中膜厚度(IMT)、血管内皮素(ET-1)、一氧化氮(NO)的变化情况。结果治疗后2组24hSBP、24hDBP、dSBP、dDBP、nSBP、nDBP、24hSBPV、24hDBPV、dSBPV、dDBPV、nSBPV、nDBPV均下降(P<0.05),观察组下降明显(P<0.05)。治疗后观察组Hcy[(7.4±2.9)μmol/L]、sICAM-1[(342.4±39.5)μg/L]、NO[(78.4±9.1)μmol/L]、ET-1[(53.4±9.6)ng/L]以及IMT[(1.0±0.6)mm]明显优于对照组[Hcy(9.2±3.0)μmol/L、sICAM-1(366.5±39.5)μg/L、NO(75.3±8.0)μmol/L、ET-1(57.4±9.8)ng/L以及IMT(1.3±0.6)mm],差异有统计学意义(P<0.05)。结论依那普利联用叶酸治疗更有利于改善H型高血压患者的血压及血压变异性,延缓动脉粥样硬化进程,改善血管内皮细胞功能,值得临床推广。Objective To evaluate the clinical efficacy of enalapril combined with folie acid in the treatment of H type hypertension and its influence on vascular endothelial function. Methods From October,2014 to October,2015,170 cases of H type hypertension patients in our hospital were selected and randomly divided into the observation group and the control group （85 cases in each group） ;The control group were given enalapril maleate tablets, while the observation group had folic acid tablets on basis of the control group;Before and 24 w after the treatment, the 24 h ambulatory blood pres- sure,the levels of Hcy,slCAM-1 ,IMT,ET-1 and NO were tested and compared. Results After the treatment,24hSBP, 24hDBP, dSBP, dDBP, nSBP, nDBP,24hSBPV,24hDBPV, dSBPV, dDBPV, nSBPV and nDBPV were all significantly de- creased in both groups （P 〈 0.05 ）, more significantly in the observation group （ P 〈 0.05 ）. After the treatment, the levels of Hcy, slCAM-1, NO, ET-1 and IMT were （ 7.4 ± 2.9 ） μmol/L, （ 342.4± 39.5 ） μg/L, （ 78.4±9.1 ） μmol/L, （ 53.4 ±9.6 ） ng/L and （ 1.0 ±0.6） mm, respectively, which were obviously superior to the control group [ （ 9.2±3.0 ） μmol/L, （ 366.5 ± 39.5 ） μg/L, （ 75.3 ± 8.0 ） μmol/L, （ 57.4 ± 9.8 ） ng/L and （ 1.3±0.6 ） mm, respectively ], the difference was statistically significant （ P 〈 0.05 ）. Conclusion Enalapril combined with folic acid can improve blood pressure and blood pressure variability in patients with H-type hypertension, which could delay the process of atherosclerosis and improve vas- cular endothelial function, worthy of clinical promotion.

关 键 词：依那普利 叶酸 H型高血压 血管内皮功能 

分 类 号：R544.1[医药卫生—心血管疾病]