马来酸依那普利叶酸对H型高血压伴左心衰竭疗效观察

Clinical Observation of Enalapril-folic Acid Tablet in Patients with H-type Hypertension Complicated with Left Heart Failure

目的：观察马来酸依那普利叶酸对H型高血压伴左心衰竭患者的疗效和保护心脏方面的作用。方法：将60例符合标准的患者按随机数字表法分为试验组和对照组各30例,两组治疗方案均按国际最新治疗指南给予强心、利尿、扩血管、减轻心脏负荷、对症等治疗。在ACEI类药物选择方面,对照组：给予马来酸依那普利治疗,10 mg,1次/d;试验组：给予马来酸依那普利叶酸片治疗,10 mg,1次/d,于2周、6个月评估心力衰竭疗效及血压、同型半胱氨酸（Hcy）的水平。结果：（1）试验组治疗2周、6个月后的Hcy水平均低于对照组,差异均有统计学意义（P〈0.05）;两组血压均显著下降,收缩压降低差异无统计学意义（P〉0.05）,试验组舒张压降低较对照组显著,差异有统计学意义（P〈0.05）。（2）两组患者经临床治疗2周后心力衰竭症状均得到缓解或减轻,6个月心脏彩超示两组心脏射血功能及舒缩功能均得到改善,心功能改善均达到Ⅰ~Ⅱ级,试验组较对照组明显。结论：马来酸依那普利叶酸和马来酸依那普利对H型高血压伴左心衰无论在降压还是在保护心脏方面都具有较好的临床疗效,马来酸依那普利叶酸组改善心功能方面更为明显。

Objective：To investigate the efficacy of Enalapril-folic acid tablet in patients with H-type hypertension complicated with left heart failure.Method：60 patients were randomly divided into two groups.The two groups were treated according to the latest international treatment guidelines and given strong heart,diuresis,expanding blood vessel,reduce the load on the heart and symptomatic treatment.The control group was treated with Enala-pril tablet 10 mg/d;while the experimental group was treated with Enalapril-folic acid tablet 10 mg/d,the effect, blood pressure and Hcy of the two groups were compared after two weeks and six months.Result：（1）After two weeks, Hcy levels of the experimental group was lower than the control group（P〈0.05）; the blood pressure,systolic blood pressure reduction between the two groups had no significant difference（P〉0.05）; diastolic blood pressure of the experimental group decreased significantly compared with the control group, the difference was statistically significant（P〈0.05）.（2）After treatment for 2 weeks, the clinical symptoms of heart failure of patients of the two groups with were alleviated or ease, cardiac ejection function and diastolic function of the two groups were improved by heart colour after 6 months, cardiac function improved achieves Ⅰ-Ⅱ level, the experimental group was more obvious than the control group. Conclusion：Enalapril-folic acid tablet and Maleic acid enalaprilat in H hypertension associated with left heart failure in both the buck and in protecting the heart has a better clinical curative effect, Enalapril-folic acid tablet group is more obvious in improving cardiac function.