摘要
目的 观察叶酸联合依那普利治疗老年H型高血压的效果及对血管内皮功能和同型半胱氨酸(Hcy)水平的影响。方法 选取2019年10月—2020年10月昆明医科大学第一附属医院收治的老年H型高血压患者82例,根据随机数字表法分为观察组和对照组,每组41例。对照组予马来酸依那普利片治疗,观察组在对照组基础上加用叶酸片治疗,2组均治疗3个月。比较2组临床疗效,治疗前后血压情况、血管内皮损伤指标[一氧化氮(NO)、血管内皮素(ET-1)]、颈动脉内—中膜厚度(IMT)、血清Hcy、血浆可溶性细胞间黏附分子-1(sICAM-1)水平及不良反应。结果 观察组治疗总有效率为95.12%,高于对照组的78.05%(χ^(2)=5.145,P=0.023)。治疗3个月后,2组收缩压、舒张压低于治疗前,且观察组低于对照组(P<0.01);2组NO水平较治疗前升高,ET-1水平较治疗前降低,且观察组升高/降低幅度大于对照组(P<0.01);2组IMT较治疗前减小,血清Hcy、血浆sICAM-1水平较治疗前降低,且观察组低于对照组(P<0.01)。观察组与对照组不良反应总发生率均为4.88%,差异无统计学意义(P>0.05)。结论 叶酸联合依那普利治疗老年H型高血压疗效显著,控制血压效果更佳,并能改善血管内皮损伤,降低Hcy水平及心脑血管疾病的发病风险,且不良反应发生率低。
Objective To observe the effect of folic acid combined with enalapril in the treatment of elderly H-type hypertension and its influence on vascular endothelial function and homocysteine(Hcy)level.Methods Eighty two elderly patients with H-type hypertension admitted to First Affiliated Hospital of Kunming Medical University from October 2019 to October 2020 were selected and divided into observation group and control group according to the random number table method,with 41 cases in each group.The control group was treated with enalapril maleate tablets,and the observation group was treated with folic acid tablets on the basis of the control group,both groups were treated for 3 months.The clinical efficacy,blood pressure,vascular endothelial injury indexes(NO,ET-1),IMT,serum Hcy,plasma sICAM-1 levels before and after treatment,and adverse reactions between the two groups were compared.Results The total effective rate of the observation group was 95.12%,which was higher than 78.05%of the control group(χ^(2)=5.145,P=0.023).After 3 months of treatment,the systolic blood pressure and diastolic blood pressure of the two groups were lower than those before treatment,and the observation group was lower than the control group(P<0.01).The levels of NO in the two groups were higher than those before treatment,and the levels of ET-1 were lower than those before treatment,and the increase/decrease amplitude of the observation group was greater than that of the control group(P<0.01).The IMT of the two groups decreased compared to before treatment,and the levels of serum Hcy and plasma sICAM-1 decreased compared to before treatment,and the observation group was lower than the control group(P<0.01).The total incidence of adverse reactions in the observation group and the control group were 4.88%,and the difference was not statistically significant(P>0.05).Conclusion Folic acid combined with enalapril in the treatment of elderly H-type hypertension has significant curative effect,better blood pressure control effect,and can improve vascular endothelial injury,reduce the level of Hcy and the risk of cardiovascular and cerebrovascular disease,and the incidence of adverse reactions is low.
作者
董丽宏
朱晓琳
何辰
王怡洁
赵海燕
DONG Lihong;ZHU Xiaolin;HE Chen;WANG Yijie;ZHAO Haiyan(Department of Critical Care Medicine,First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)
出处
《临床合理用药杂志》
2024年第4期1-3,7,共4页
Chinese Journal of Clinical Rational Drug Use
基金
云南省科技厅昆明医科大学联合专项基金(202001AY070001-205)。
关键词
H型高血压
叶酸
依那普利
血压
血管内皮功能
同型半胱氨酸
H-type hypertension
Folic acid
Enalapril
Blood pressure
Vascular endothelial function
Homocysteine
