卡维地洛联合依那普利叶酸片对H型高血压心力衰竭患者同型半胱氨酸、心功能的影响

Effects of carvedilol combined with enalapril folic acid tablets on homocysteine and cardiac function in patients with H type hypertension and heart failure

目的:研究卡维地洛联合依那普利叶酸片治疗前、后H型高血压心力衰竭患者血浆同型半胱氨酸浓度、心功能及心室重构变化情况。方法:选取2018年3月~2019年10月在我院接受治疗的106例H型高血压心力衰竭患者为研究对象,采用随机数字表法将106例H型高血压心力衰竭患者分为对照组和观察组,每组各53例。所有患者入院后均给予高血压及抗心衰常规治疗,包括:低钠饮食,给予强心剂、利尿剂、血管紧张素II受体拮抗、β受体阻滞剂。在常规治疗的基础上,对照组患者给予卡维地洛治疗;观察组给予卡维地洛和依那普利叶酸片治疗,两组均连续治疗6个月。观察两组治疗前后血浆同型半胱氨酸(Hcy)、N末端B型脑钠肽原(NT-proBNP)水平,以及心室重构(LVDd、LVPWT、IVST、LVMI)和心功能指标(LVEF、E/A)变化,比较两组治疗疗效、治疗后主要不良心血管事件及不良反应发生率。结果:治疗前两组各指标比较无统计学意义。治疗后,两组血浆Hcy、NT-proBNP平均下降,且观察组各指标水平均低于对照组,差异有统计学意义;治疗后,两组心室重构(LVDd、LVPWT、IVST、LVMI)和心功能指标(LVEF、E/A)均有改善,且观察组各指标比对照组有显著改善。观察组总有效率大于对照组,治疗6个月后不良心血管事件低于对照组。两组治疗期间不良反应发生率比较无统计学意义。结论:卡维地洛联合依那普利叶酸片可有效改善患者心室重构和心功能,纠正血浆同型半胱氨酸浓度。其临床疗效优于卡维地洛单用,能有效减少不良心血管事件发生,且不增加不良反应。

Objective To study the changes of plasma homocysteine concentration,cardiac function and ventricular remodeling in patients with H type hypertensive heart failure before and after treatment with carvedilol and enalapril folate tablets.Methods 106 patients with H type hypertension heart failure received treatment in our hospital from March 2018 to October 2019were randomly divided into two groups:control group and observation group.There were 53 cases in each group.All patients were admitted to the hospital for routine treatment of hypertension and anti-heart failure,including a low-sodium diet,cardiopressin,diuretics,and angiotensin.II receptor antagonist,β-receptor blocker.On the basis of routine treatment,the patients in the control group were treated with carvedilol,while the patients in the observation group were treated with carvedilol and enalapril folic acid tablets for 6 months.The changes of plasma homocysteine(Hcy),N terminal B-type brain natriuretic peptide(NT-proBNP),ventricular remodeling(LVDd,LVPWT,IVST,LVMI)and cardiac function index(LVEF,E/A)were observed before and after treatment.The incidence of major adverse cardiovascular events and adverse reactions after treatment.Results Before treatment,the two groups There was no significant difference between the indexes.After treatment,plasma Hcy,NT-proBNP decreased significantly in the two groups,and the levels of each index in the observation group were lower than those in the control group.After treatment,ventricular remodeling(LVDd,LVPWT,IVST,LVMI)and cardiac function index(LVEF,E/A)were improved in both groups,and each index in the observation group was significantly improved than that in the control group.The total effective rate in the observation group was higher than that in the control group,and the adverse cardiovascular events were lower in the observation group than in the control group after 6 months of treatment.Two There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Carvedilol combined with enalapril folate tablets can effectively improve ventricular remodeling and cardiac function and correct plasma homocysteine concentration.Its clinical effect is better than carvedilol alone,can effectively reduce adverse cardiovascular events,and does not increase adverse reactions.