钙离子拮抗剂联合叶酸治疗伴H型高血压急性脑梗死的临床分析  

Clinical Analysis of Calcium Channel Blockers Combined with Folic Acid in The Treatment of Acute Cerebral Infarction with H-type Hypertension

作　　者：康聚贤[1] 张培[1] 尹少华[1] 马赟英 陈欣[1] 

机构地区：[1]河北省邢台市人民医院神经内三科,河北邢台054001

出　　处：《系统医学》2016年第9期33-37,共5页Systems Medicine

基　　金：河北省邢台市科技支撑计划项目(2014ZC155)

摘　　要：目的通过观察不同钙离子拮抗剂联合叶酸治疗对伴H型高血压急性脑梗死患者的血压水平、血浆同型半胱氨酸水平及神经功能评分影响,研究不同钙离子拮抗剂联合叶酸对伴有H型高血压的急性脑梗死的治疗作用及预后影响。方法选择2015年2—11月在邢台市人民医院住院的142例符合入组条件的患者随机分为治疗一组47例、治疗二组48例、对照组47例,治疗一组给予尼莫地平40 mg tid+叶酸2.5 mg/d,治疗二组给予尼群地平片10 mg bid+叶酸2.5 mg/d,对照组给予尼莫地平40 mg tid,其它用药3组基本相同。分别于治疗前,治疗后1、2、3周时分别测量血压水平、血浆同型半胱氨酸(Hcy)水平及血清叶酸(SFA)水平;另外,分别于治疗前、12周后测量患者NIHSS评分和Barthel指数评分。结果治疗3周时治疗一组患者收缩压(132.42±12.41)mmHg、舒张压(83.94±9.34)mmHg,治疗二组收缩压(131.27±11.78)mmHg、舒张压(82.63±10.03)mmHg均优于对照组收缩压(140.93±12.76)mmHg、舒张压(95.04±9.56)mmHg,差异有统计学意义(P<0.05),治疗一组血浆Hcy水平(9.86±2.73)μmol/L、SFA水平(19.3±0.24)nmol/L,治疗二组血浆Hcy水平(9.34±3.37)μmol/L、SFA水平(19.2±0.23)nmol/L均优于对照组血浆Hcy水平(14.43±3.42)μmol/L、SFA水平(8.8±2.2)nmol/L,差异有统计学意义(P<0.05),12周时治疗一组患者NIHSS评分(3.82±1.41)分、Barthel指数评分(68.94±9.34)分优于治疗二组NIHSS评分(4.57±1.78)分、Barthel指数评分(61.63±10.03)分及对照组NIHSS评分5.53±1.76)分、Barthel指数评分(54.04±9.56)分,差异有统计学意义(P<0.05)。Pearson相关分析血浆Hcy与SFA的表达成负相关,治疗一组(r=-0.976,P=0.024<0.05),治疗二组(r=-0.984,P=0.016<0.05)。结论钙离子拮抗剂联合叶酸能有效控制伴H型高血压急性脑梗死患者的血压水平,降低血浆同型半胱氨酸,改善急性脑梗死患者预后,且尼莫地平联合叶酸治疗可能使预后获益更大,同时药物�Objective To find the therapeutic and prognostic effects of different Calcium Channel Blockers combined with folic acid on the patients with H type hypertension and cerebral infarction by observing the effect of the level of blood pressure、plasma homocysteine （Hcy）and Barthel index. Methods From Februay 2015 to November 2015＆amp;nbsp;142 patients met the inclusion criteria were randomly divided into three groups.In the treatment group Ⅰ （n=47）,the patients were cured with nimodipine 40 mg tid＋folic acid 2.5mg qd,the patients of the treatment group Ⅱ （n=48）re-ceived nitrendipine 10mg bid＋folic acid 2.5 mg qd,and the control group （n=47）were cured with nimodipine 40mg tid. The other medication of the three groups were same. Before treatment, after treatment 1 week, 2 weeks and 3 weeks,the blood pressure levels,plasma homocysteine levels and plasma folate levels were measured. In additionally, before treat-ment, and 12 weeks later, to assessed the patients with NIHSS score and Barthel Index score. Results After 3 weeks, The systolic blood pressure and the diastolic blood pressure of treatment groupⅠ （132.42±12.41）mmHg,（83.94±9.34） mmHg and treatment groupⅡ（131.27±11.78）mmHg,（82.63±10.03）mmHg, were better than that of contorl group（140.93± 12.76）mmHg,（95.04±9.56）mmHg,and the difference was statistically significant （P〈0.05）,the plasma homocysteine levels and serum folate acid levels of patients in treatment groupⅠ（9.86±2.73）μmol/L,（19.3±0.24）nmol/L and treatment groupⅡ（9.34±3.37）μmol/L,（19.2±0.23）nmol/L were better than that of control group（14.43±3.4）μmol/L,（8.8±2.2）nmol/L,and the different was statistically significant （P〈0.05）. The NIHSS scores （3.82±1.41）points of treatment groupⅠ after 12 weeks of treatment was lower than in the treatment groupⅡ （4.57±1.78）points and control group （5.53±1.76）points,and the difference was statistically significant（P〈0.05）. The Barthel index score

关 键 词：H型高血压 急性脑梗死 钙离子拮抗剂 叶酸 

分 类 号：R743[医药卫生—神经病学与精神病学]