依那普利叶酸片对“H型”高血压患者颈动脉内膜中层厚度和凝血-纤溶功能指标的影响

Effect of Enalapril Folic Acid Tablets on Carotid Intima-media Ihickness and Coagulation-fibrinolysis Indicators in Patients with "H-type" Hypertension

目的探讨依那普利叶酸片对"H型"高血压患者颈动脉内膜中层厚度(IMT)和凝血-纤溶功能指标的影响。方法选取2009年6月—2013年8月我院就诊的"H型"高血压患者786例,将其随机分为两组,依那普利叶酸治疗组(依那普利叶酸10 mg∶0.8 mg/次,1次/d)391例和依那普利治疗组(依那普利10 mg/次,1次/d)395例,疗程均为24个月。观察两组治疗前、治疗后12个月和24个月同型半胱氨酸(Hcy)、IMT以及相关凝血-纤溶指标〔包括血浆纤维蛋白原(Fg)、血管性假血友病因子(vWF)、抗凝血酶Ⅲ抗原(AT-ⅢAg)、D-二聚体(D-D)、组织型纤溶酶原激活物抗原(t-PA Ag)和纤溶酶原激活物抑制物-1(PAI-1)〕的变化。结果治疗12个月和24个月,依那普利叶酸治疗组Hcy、IMT、D-D、PAI-1及IMT低于依那普利治疗组(P<0.05),t-PA Ag高于依那普利治疗组(P<0.05)。结论依那普利叶酸片治疗"H型"高血压,在降Hcy的同时能明显抑制IMT增厚,改善部分凝血-纤溶功能。

Objective To study the effect of Enalapril folic acid tablels on the carotid artery intima media thielkness （IMT）, and eoagtahtion - fibrinolysis indexes in patients with ＂ H- type＂ hyperiension.Metbods 786 patierns.with H-type hypertension were ehosen in our hospital from June 2909 to August 2013, they were randomly divided into 2 groups：enalapril folic aeid treatment group （ enalapril folic acid 10mg： 0. 8mg/times, 1 times/d）and enalapril treatment group（enalapnil 10mg/times, 1 times/d）, all treatment for 24 months. The Hey, IMT, related coagulation -fibrinolysis[including plasma fibrinogen （Fg） , yon Willcbrand factor（ vWF）,antithrombin Ⅲ antigce（AT-ⅢAg）,D-dimer（DD）,orgarnization antigentype plasminogen activator （t-PA Ag） and plasmirrogen activator inhibitor-1 （PAl -1 ）] were deteced before and after 12months and 24 months treatment. Results After treatment for 12 months and 24 months, the Hcy,IMT,D-D,PAI-1 andIMT of enalaprit f01ic acid treatment group were lower than those of enalapril treatment group （ P 〈 0. 05）; t - P/t Ag higher than that of enalapril treatment group （ P 〈 0. 05 ）. Conclusion Enalapril folio aeiii tablets in the treatment of＂ H - type＂ hyperten- sion, but also decrease carotid intima -media thickness severity, At the same time lowering： Hcy, can inhibit the proliferation of IMT, improve partial thromboplastin- fibrinolysis.