依那普利叶酸片治疗伴有高同型半胱氨酸血症原发性高血压卒中患者临床疗效

Clinical efficacy of enalapril folic acid tablets in the treatment of patients with hypertensive stroke accompanied by hyperhomocysteinemia

目的探讨依那普利叶酸片治疗伴有高同型半胱氨酸(Hcy)血症原发性高血压卒中患者临床效果。方法选取2017年6月至2017年11月丰县人民医院治疗的伴有高Hcy血症原发性高血压卒中患者120例作为研究对象,随机分为观察组和对照组,每组60例。观察组采用依那普利叶酸片治疗,对照组采用马来酸依那普利治疗,疗程均6个月,对比两组患者的血压、Hcy水平、美国国立卫生研究院卒中量表(NIHSS)评分和卒中的复发率。结果治疗后,两组患者的收缩压、舒张压均显著降低(P<0.05),组间药物降压效果比较差异无统计学意义(P>0.05),治疗后观察组Hcy水平(8.59±2.19)μmol/L、NIHSS评分(12.13±5.74)分明显低于对照组的Hcy水平(15.18±2.06)μmol/L、NIHSS评分(15.92±4.60)分,差异有统计学意义(P<0.05)。随访6个月,观察组患者卒中的复发率是3.33%,对照组的复发率是5.00%,差异无统计学意义(P>0.05)。两组治疗期间均无严重不良反应发生,低血压发生率比较差异无统计学意义(P>0.05)。结论依那普利叶酸片可有效降低伴有高Hcy血症原发性高血压卒中患者的血Hcy水平,控制血压,改善卒中患者的神经功能,能显著提高临床疗效,但未观察到降低血Hcy能预防卒中复发的作用。

Objective To analyze the clinical effect of enalapril folic acid tablets in the treatment of patients with hypertensive stroke accompanied by hyperhomocysteinemia.Methods A total of 120 patients with hypertensive stroke accompanied by hyperhomocysteinemia who were treated in Fengxian People’s Hospital from June to November 2017 were randomly divided into observation group(n=60)and control group(n=60).The observation group was treated with enalapril maleate folic acid tablets,the control group was treated with enalapril maleate,and the treatment course in the two group were all 6 months.The blood pressure,homocysteine(Hcy)concentration,NIHSS score and stroke recurrence rate were compared between the two groups.Results After treatment,the systolic and diastolic blood pressures of the two groups were significantly decreased(P<0.05).There was no significant difference in the antihypertensive effect between the two groups(P>0.05).The Hcy level(8.59±2.19)μmol/L and NIHSS scores(12.13±5.74)were significantly lower than those of the control group[Hcy level(15.18±2.06)μmol/L and NIHSS scores(15.92±4.60)],and the differences were statistically significant(P<0.05).After 6 months of follow-up,the probability of recurrence of stroke in the observation group was 3.33%,which in the control group was 5%,and the difference was not statistically significant(P>0.05).There was no serious adverse reaction in the two groups,and there was no significant difference in the incidence of low blood pressure between the two groups(P>0.05).Conclusion Enalapril folic acid tablets can improve the neurological function of stroke patients by reducing blood Hcy levels and controlling blood pressure in patients with hypertensive stroke accompanied by hyperhomocysteinemia.However,blood Hcy reduction can not prevent the recurrence of stroke.