依那普利叶酸片改善H型高血压左室肥厚患者的心功能

Improving effect of enalapril maleate and folic acid tablets on heart function in patients with H-type hypertension and left ventricular hypertrophy

目的观察依那普利叶酸片改善H型高血压左室肥厚患者心功能的作用。方法纳入160例H型高血压左室肥厚患者,随机分为依那普利组(n=80)和依那普利叶酸片组(依叶组)。治疗12个月后,观察两组患者血压、心功能及血浆同型半胱氨酸(Hcy)水平的变化。结果 1两组患者治疗后收缩压(SBP)、舒张压(DBP)与治疗前比较,均有非常显著性降低(P<0.01),治疗后两组患者间SBP、DBP比较均有统计学差异(P均<0.05),且依叶组降血压效果更明显。2治疗后,依叶组患者血浆Hcy水平与治疗前相比显著降低(P<0.01),依那普利组患者血浆Hcy水平与治疗前相比有明显降低(P<0.05);两组患者治疗后血浆Hcy水平比较有显著统计学差异(P<0.01),且依叶组血浆Hcy水平降低更明显。3两组患者治疗后左室舒张早期二尖瓣血流峰速度(E)及晚期血流峰速度(A)比值(E/A)及左室射血分数(LVEF)值与治疗前比较均显著升高(P<0.01),治疗后两组患者间E/A值、LVEF值比较均有统计学差异(P<0.05),且依叶组升高效果更明显。结论依那普利叶酸片能更好的降低H型高血压左室肥厚患者血压及血浆Hcy水平,改善左室的舒张及收缩功能。

Objective To observe the improving effect of enalapril maleate and folic acid tablets on heart function in patients with H-type hypertension and left ventricular hypertrophy （LVH）.Methods The patients （n=160） were chosen and divided randomly into enalapril maleate group （EM group,n=80） and enalapril maleate and folic acid tablets group （EMFA group,n=80）. After treatment for 12 m, the changes of blood pressure, heart function and level of plasma homocysteine （Hcy） were observed in 2 groups.Results ①SBP and DBP decreased significantly after treatment in 2 groups （P〈0.01）, and the comparisons in SBP or DBP had statistical differences between 2 groups after treatment （allP〈0.05）. Blood pressure decreased much significantly in EMFA group. ②After treatment, the level of plasma Hcy decreased significantly in EMFA group （P〈0.01） and decreased in EM group （P〈0.05）, and the comparison in level of plasma Hcy had significantly statistical difference between 2 groups after treatment （P〈0.01）. The level of plasma Hcy decreased much significantly in EMFA group. ③The ratio of left ventricular peak early diastolic mitral flow velocity （E） and late peak flow velocity （A, E/A） and LVEF increased significantly in 2 groups after treatment （P〈0.01）. The comparisons in E/A and LVEF had statistical differences between 2 groups after treatment （P〈0.05）, which were more significant in EMFA group.Conclusion Enalapril maleate and folic acid tablets can reduce blood pressure and level of plasma Hcy and improve left ventricular diastolic and systolic functions in patients with H-type hypertension and LVH.