马来酸依那普利叶酸片治疗老年性H型高血压的临床研究

Clinical effect of enalapril maleate and folic acid tablets on treatment of senile patients with H-type hypertension

目的观察马来酸依那普利叶酸片(依叶)治疗H型高血压的效果。方法选取134例H型高血压患者,分为高暴露组、低暴露组和未暴露组。对所有患者进行1年以上的随访,记录患者的实际用药情况,不良反应和终点事件发生情况。分别在登记后的第1天(治疗前)和1年后测定3组患者的收缩压、舒张压以及同型半胱氨酸(HCY)水平、空腹血糖(FBG)、餐后2 h血糖(2 hBG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)、谷丙转氨酶(ALT)的变化。结果 3组患者的收缩压、舒张压和HCY水平在治疗后均显著下降(P<0.05)。3组患者的FBG、2 hBG、HbAlc在治疗后均显著降低(P<0.05),且治疗后高暴露组的FBG、2 hBG、HbAlc指标均低于低暴露组和未暴露组(P<0.05)。3组患者的TG、TC、LDL-C和UA在治疗后均显著下降(P<0.05)。高暴露组的终点事件发生率显著高于低暴露组和未暴露组(P<0.05)。结论以依叶作为基础药物治疗老年性H型高血压能够明显降低患者HCY水平。

Objective To observe the effect of enalapril maleate and folic acid tablets on treatment of senile patients with H-type hypertension. Methods A total of 144 senile patients with H-type hypertension were selected and divided into high exposed group, low exposed group and non- exposed group, respectively. All the patients were followed up for at least one year, and the drug ap- plication, adverse reactions and cardiovascular end points were recorded. The systolic blood pressure, diastolic blood pressure, HCY, FBG, 2 hBG, HbAlc, TG, TC, HDL-C, LDL-C, UA and ALT were observed after one year of treatment. Results The HCY, systolic and diastolic blood pressure of three groups all decreased significantly after treatment （P 〈0.05）. The FBG, 2 hBG and HbAlc of three groups decreased significantly after treatment （P 〈0.05）, and the FBG, 2 hBG, HbAlc of high exposed group after treatment were significantly less than low exposed group and non-exposed group （P 〈 0.05 ）. The TG, TC, LDL-C and UA of three groups all decreased significantly after treatment （P 〈 0.05 ）. The incidence rate of cardiovascular end points of high exposed group was sig- nificantly less than low exposed group and non-exposed group （P 〈 0.05 ）. Conclusion Enalapril maleate and folic acid tablets can reduce the HCY and blood pressure of senile patients with H-type hypertension.