叶酸与奥美沙坦酯夜间联用对非杓型H型高血压患者血压、炎症因子及内皮功能的影响  

Effects of Folic Acid Combined with Olmesartan Ester at Night on Blood Pressure,Inflammatory Factors and Endothelial Function in Patients with Non-dipper Type H Hypertension

作　　者：袁龙 边丽丽 王丹 侯春霞 王俊芝 YUAN Long;BIAN Li-li;WANG Dan;HOU Chun-xia;WANG Jun-zhi(Changzhi People's Hospital,Changzhi 046000,China)

机构地区：[1]长治市人民医院,山西长治046000

出　　处：《药物生物技术》2023年第6期596-600,共5页Pharmaceutical Biotechnology

摘　　要：观察叶酸与奥美沙坦酯夜间联用对非杓型H型高血压患者患者血压、炎症因子及内皮功能的影响。选取2020年01月至2021年01月本院收治的186例非杓型H型高血压患者为对象,采用奇偶数分组法分为对照组91例和观察组95例。对照组给予奥美沙坦酯治疗,观察组给予叶酸夜间联合奥美沙坦酯治疗。比较两组动态血压、冠状动脉内皮功能、血清同型半胱氨酸(Hcy)、炎症因子、脉搏波传导速度(PWV)的差异,统计两组安全性、杓型高血压发生率及心血管疾病危险分层情况。两组治疗前动态血压、Hcy、炎症因子、PWV比较,未见统计学差异(P>0.05);与治疗前相比,两组血清Hcy、肿瘤坏死因子-α(TNF-α)、PWV、高敏-C反应蛋白(hs-CRP)及日间、夜间、24 h的收缩压(SBP)和舒张压(DBP)均较前下降,其中观察组治疗后Hcy、炎症因子、PWV及夜间和24 h SBP低于对照组,其他血压状态与对照组比较,未见统计学差异(P>0.05)。两组治疗前冠状动脉内皮功能比较,未见统计学差异(P>0.05);与治疗前相比,两组治疗后前降支中远段峰值血流速度变化率(△V_(LAD))、左主干内径变化率(△D_(LM))均较前下降,且观察组下降更明显(P<0.05)。两组治疗后前降支中远段峰值血流速度(V0_(LAD))、左主干内径(D0_(LM))与治疗前、对照组比较,均未见统计学差异(P>0.05)。观察组杓型高血压发生率为56.84%(54/95)高于对照组的41.76%(38/91),不良反应发生率为9.47%(9/95)与对照组的6.59%(6/91)比较,未见统计学差异(P>0.05)。观察组心血管疾病危险分层优于对照组,有统计学差异(P<0.05)。叶酸与奥美沙坦酯夜间联用可改善非杓型H型高血压患者冠状动脉内皮功能,降低心血管疾病风险,纠正血压昼夜节律,且不增加不良反应。The aim of this study is to investigate the effects of folic acid combined with olmesartan ester at night on blood pressure,inflammatory factors,and endothelial function in patients with non-dipper type H hypertension.A total of 186 patients with non-dipper type H hypertension who were admitted to the authors'hospital from January 2020 to January 2021 were enrolled in this study.The patients were divided into two groups using an odd-even number grouping method:the control group(n=91)and the observation group(n=95).The control group received treatment with olmesartan ester,while the observation group received treatment with folic acid and olmesartan ester at night.The study compared ambulatory blood pressure,coronary artery endothelial function,serum homocysteine(Hcy),inflammatory factors,and pulse wave velocity(PWV)between the two groups.The safety,incidence of dipper type hypertension,and risk stratification of cardiovascular disease were also analyzed statistically.Before treatment,there were no significant diffe-rences in ambulatory blood pressure,Hcy,inflammatory factors,and PWV between the two groups(P>0.05).After treatment,Hcy and TNF-αin the serum of both groups,PWV,high-sensitivity C-reactive protein(hsCRP),day-time,night-time,and 24-hour systolic and diastolic blood pressure were all significantly lower compared to before treatment.The observation group had lower levels of Hcy,inflammatory factors,PWV,night-time,and 24-hour SBP compared to the control group post-treatment.However,there were no signi-ficant differences in other blood pressure states and the control group(P>0.05).There were no significant differences in coronary endothelial function between the two groups before treatment(P>0.05).After treatment,the change rate of peak blood flow velocity(△V_(LAD))and the change rate of left trunk diameter(△D_(LM))in the middle and far segments of the anterior descending branch in both groups were lower than before treatment,with the decrease in the observation group being more significant(P<0.05).The

关 键 词：叶酸 奥美沙坦酯 非杓型H型高血压 心血管疾病风险 冠状动脉内皮功能 不良反应 

分 类 号：R544.1[医药卫生—心血管疾病]