依那普利联合叶酸对高血压患者血管内皮功能及尿微量白蛋白的影响

Effect of enalapril combined with folate acid on endothelial function and urine microalbumin in patients with hypertension

目的 探讨依那普利联合叶酸治疗对原发性高血压患者血管内皮功能及尿微量白蛋白（UMA）的影响。方法 120例原发性高血压患者按数字表法随机分为对照组和治疗组,各60例。对照组给予依那普利降压治疗（10 mg,每天1次）,观察组给予依那普利联合叶酸片（0.4 mg,每天1次）治疗,疗程8周。观察治疗前后血压、血浆同型半胱氨酸（Hcy）、肱动脉内皮依赖性舒张功能（FMD）和UMA变化。结果 观察组与对照组降压有效率差异无统计学意义（75.0%与71.7%,P＞0.05）;观察组Hcy、FMD和UMA均较对照组明显改善［分别为（10.2±5.8）μmol/L与（16.6±8.1）μmol/L、（14.8±5.4）%与（8.2±3.5）%、（14.8±5.4）mg/L与（31.6±9.5）mg/L,t=3.641、7.325、8.221,均P＜0.05］。结论 依那普利联合叶酸治疗原发性高血压能降低Hcy,修复血管内皮功能,减少UMA。

Objective To explore the effect of enalapril combined with folate acid on endothelial function and urine microalbumin（UMA） in patients with hypertension.Methods 120 patients with hypertension were randomly divided into two groups：control group（n=60） was given enalapril 10.0mg/d,observation group（n=60） received enalapril 10.0mg＋folic acid 0.4mg/d.The total treatment period was 8 weeks.Blood pressure,plasma homocysteine（Hcy）,flow mediated dilation（FMD） and UMA were examined.Results The efficacy of pressure releasing had no significant difference between two groups.Hcy[（10.2±5.8）μmol/L vs （16.6±8.1）μmol/L,t=3.641],FMD[（14.8±5.4）% vs （8.2±3.5）%,t=7.325] and UMA[（14.8±5.4）mg/L vs （31.6±9.5）mg/L,t=8.221] of two groups were significantly different after treatment.Conclusion Combination therapy of enalapril and folate acid can decrease plasma Hcy and UMA,restore vascular endothelium function in patients with hypertension.