依那普利联合叶酸片治疗H型高血压疗效及作用机制探讨

Curative effects of byenalapril combined with folic acid tablets on Hypertension and its mechanism

目的:观察依那普利联合叶酸片对H型高血压患者血清同型半胱氨酸、炎性因子及血管内皮损伤的影响。方法:将92例H型高血压患者随机分为观察组和对照组各46例,对照组给予马来酸依那普利片进行治疗,观察组在对照组基础上联合应用叶酸片进行治疗,比较两组血清同型半胱氨酸(Hcy)、炎性因子及血管内皮损伤相关指标的变化情况。结果:两组治疗有效率比较,差异无统计学意义(P>0.05);治疗后两组Hcy、叶酸、维生素B1 2、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-9(MMP-9)、一氧化氮(NO)及血管内皮素(ET-1)各指标水平均优于治疗前,但观察组各指标与对照组比较,改善情况更加明显,差异均具有统计学意义(P<0.05)。结论:对于H型高血压患者的而言,应用依那普利片治疗可在一定程度上改善患者血压,降低Hcy水平,改善血管内皮功能,缓解炎性反应,若联合使用一定剂量的叶酸,临床疗效更佳,可将其作为H型高血压患者目前治疗的较为理想的方法。

Objective： To observe influence of byenalapril combined with folic acid tablets on serum homocysteine, in- flammatory factors and endothelial iniury in hypertension patients. Methods： 92 cases of H type hypertension patients were randomly divided into the observation group and control group with 46 cases in each group. Both groups were given enalapril maleate tablets, the observation group was also given folic acid tablets, then compared changes in serum homocysteine cysteine （Hcy）, inflammatory factor and vascular endothelial injury related indicators between the two groups. Results： No significant difference in effective rate was found between the two groups （P〉0.05）. After treatment, Hcy, CPR, B12, TNF-α, MMP-9, NO and ET-1 of both groups were superior to that before the treatment, but the improvement was more obvious in the obser- vation group （P〈0.05）. Conclusion： For the H type hypertension patients, enalapril maleate tablets can improve blood pres- sure, reduce Hcy levels, improve endothelial function, alleviate the inflammatory reaction. The clinical curative effect is even better when it is combined with folic acid. Thus enalapril maleate tablets combing with folic acid is an idea therapy for H type hypertension.