依那普利叶酸片与依那普利治疗H型高血压伴慢性心力衰竭疗效比较  

Efficacy of enalapril folic acid tablets and enalapril in treatment of H type hypertension complicated with chronic heart failure

作　　者：段凌菱[1] 孙向阳[1] 冯达应[1] DUAN Ling-lin;SUN Xiang-yang;FENG Da-yin(Department of Cardiology, Dazhou Central Hospital, Dazhou, Sichuan 635000, Chin)

机构地区：[1]达州市中心医院心内科,四川达州635000

出　　处：《热带医学杂志》2018年第6期803-806,共4页Journal of Tropical Medicine

摘　　要：目的比较依那普利叶酸片与依那普利治疗H型高血压伴慢性心力衰竭(CHF)的疗效。方法选取2013年1月-2015年6月就诊的90例符合标准的H型高血压伴左心室收缩功能不全患者,随机分为依那普利组和依那普利叶酸片组(依叶组),每组各45例。根据统一心衰指南,给予强心、利尿及改善心肌重塑治疗,依那普利组给予依那普利片,依叶组给予依那普利叶酸片,治疗1年观察两组患者血压、心功能、脑钠肽(BNP)及血浆同型半胱氨酸(Hcy)水平的变化。结果两组患者治疗后收缩压、舒张压均较治疗前显著降低,治疗前后差异有统计学意义(P<0.05),且治疗后依叶组显著低于依那普利组(P<0.05)。治疗后,两组患者血浆Hcy水平均较治疗前降低(P<0.05),且治疗后依叶组血浆Hcy水平显著低于依那普利组,差异有统计学意义(P<0.05)。治疗后,两组患者BNP水平与治疗前相比均降低(P<0.05),且治疗后依叶组显著低于依那普利组,差异有统计学意义(P<0.05)。患者治疗前血清Hcy与BNP呈现明显的正相关,随着血清Hcy水平的升高,血清BNP明显升高(r_(pearson)=0.69,P<0.05)。结论依那普利叶酸片能更好地降低H型高血压伴心力衰竭患者血压及血浆Hcy水平,更好改善此类患者心功能。Objective To compare the efficacy of enalapril and enalapril folic acid tablets in the treatment of H type hypertension with chronic heart failure（CHF）.Methods 90 patients in our hospital with standard H type hypertension with left ventricular systolic dysfunction choosed from Jan.2013 to Jun.2015;the patients were randomized for enalapril and enalapril folic acid tablets group（according to leaf group）with 45 cases each.According to the unified heart failure guidelines to provide strong heart,diuresis and improving myocardial remodeling treatment.The enalapril group treated with enalapril,and the enalapril folic acid tablets group was given enalapril folic acid tablets;The treatment was last for one year;the blood pressure,heart function,brain natriuretic peptide（BNP）and plasma homocysteine（Hcy）level changes of both groups were recorded.Results The systolic blood pressure and diastolic blood pressure of the two groups were significantly decreased after treatment（P〈0.05）,and the enalapril folic acid tablets group of the enalapril folic group was significantly lower than that of the enalapril group（P〈0.05）.After treatment,the plasma Hcy levels of the two groups were lower than those before treatment（P〈0.05）,and the level of plasma Hcy in the enalapril folic group was significantly lower than that in the enalapril group（P〈0.05）.After treatment,the levels of BNP in the two groups were lower than those before treatment（P〈0.05）,and the the levels of plasma brain natriuretic peptide of the enalapril folic group was significantly lower than that of the enalapril group（P〈0.05）.Serum Hcy was positively correlated with BNP before treatment,and serum BNP increased significantly with the increase of serum Hcy level（rpearson=0.69,P〈0.05）.Conclusion Enalapril folic acid tablets can better reduce blood pressure and plasma Hcy levels in patients with H-type hypertension and heart failure,and better improve heart function in these patients.

关 键 词：依那普利叶酸片 H型高血压 心力衰竭 同型半胱氨酸 脑钠肽 

分 类 号：R544.1[医药卫生—心血管疾病]