依那普利叶酸片对中青年H型高血压患者血压和血压变异性的影响

Effect of Enalapril-folic aicd on blood pressure and its variability in young and middle-aged patients with H-type hypertension

目的探讨依那普利叶酸片对中青年H型高血压患者血压和血压变异性的影响。方法选择未经治疗的中青年H型高血压患者102例,随机分为对照组50例,服用依那普利片,实验组52例,服用依那普利叶酸片,共24周。采用24 h动态血压监测方法测定治疗前及治疗后24周的24 h平均收缩压、舒张压及24 h、白昼和夜间收缩压及舒张压标准差,同时测定治疗前后血浆同型半胱氨酸水平。结果实验组血浆同型半胱氨酸水平、24 h收缩压标准差、白昼收缩压标准差及夜间收缩压标准差较治疗前明显下降(P<0.05),24 h舒张压标准差、白昼舒张压标准差和夜间舒张压标准差较治疗前稍有下降,但差异无统计学意义(P>0.05)。对照组24 h收缩压标准差、白昼收缩压标准差、夜间收缩压标准差、24 h舒张压标准差、白昼舒张压标准差、夜间舒张压标准差及同型半胱氨酸水平较治疗前虽有下降趋势,但差异无统计学意义(P>0.05);实验组和对照组24 h平均收缩压、24 h平均舒张压均较治疗前明显下降(P<0.001),但两组治疗后血压比较差异无统计学意义(P>0.05)。结论依那普利片和依那普利叶酸片对中青年H型高血压患者均有良好的降压疗效;依那普利叶酸片在降低血压的同时,能明显降低中青年H型高血压患者的收缩压变异性及血浆同型半胱氨酸水平。

Objective To investigate effect of Enalapril-folic aicd on blood pressure and blood pressure variability in young and middle-aged patients with H-type hypertension.Methods A total of 102 young and middle-aged cases with untreated essential H-type hypertension were chosen.They were randomly divided into control group treated with Enalapril alone（50 cases）and experimental group treated with Enalapril-folic acid（52 cases）.All were followed up for 24 weeks.Twenty-four hour ambulatory blood pressure monitoring method was used to determine the average systolic blood pressure and diastolic blood pressure of 24 hours,standard deviation of 24-hour systolic blood pressure and 24-hour diastolic blood pressure,standard deviation of diurnal systolic blood pressure and diastolic blood pressure and standard deviation of nocturnal systolicl blood pressure and nocturnal diastolic blood pressure before treatment and 24 weeks after treatment.Plasma level of homocysteine was detected before treatment and 24 weeks after treatment.Results In the experimental group,plasma level of homocysteine,standard deviation of 24-hour systolic blood pressure,daytime systolic blood pressure and nighttime systolicl blood pressure significantly decreased（P〈0.05）compared with those before treatment.The experimental group＇s standard deviation of 24-hour diastolic blood pressure,daytime diastolic blood pressure and nighttime diastolic blood pressure decreased slightly compared with those before treatment;but there were no significant differences（P〉0.05）.Plasma level of homocysteine,standard deviation of 24-hour systolic blood pressure,daytime systolic blood pressure,nighttime systolicl blood pressure,24-hour diastolic blood pressure,daytime diastolic blood pressure and nighttime diastolic blood pressure decreased slightly after treatment in the control group;but there were no significant differences（P〉0.05）.In the experimental group and the control group 24-hour average systolic blood pressure and 24-hour average diastolic blood pressure significantly lowered compared to those before treatment（P〈 0.001）.But the difference in the antihypertensive effect was not statistically significant between both groups（P〉0.05）.Conclusions Blood pressure can be effectively lowered by both Enalapril and Enalapril-folic aicd in young and middle-aged patients with H-type hypertension.Systolic blood pressure variability and homocysteine level are obviously reduced by Enalapril-folic aicd in the patients.