马来酸依那普利叶酸片对H型高血压患者血栓前状态的影响研究

Impact of Enalapril Maleate Folic Acid Tablets on Prethrombotic State in Patients with H-type Hypertension

目的探讨马来酸依那普利叶酸片对H型高血压患者血栓前状态的影响。方法于2014年6月—2015年9月选取在南昌大学第一附属医院就诊的高血压1级患者126例。根据血清同型半胱氨酸(Hcy)水平,将纳入患者分为单纯高血压组(Hcy<10μmol/L,n=35)和H型高血压组(Hcy≥10μmol/L,n=91);采用随机数字表法,将H型高血压组患者分为对照组(n=46)和试验组(n=45)。单纯高血压组和对照组患者口服马来酸依那普利片,试验组患者口服马来酸依那普利叶酸片,均连续服用6个月。结果 H型高血压组患者血小板α颗粒膜糖蛋白(CD_(62p))、血小板溶酶体膜蛋白(CD_(63))、血管性假性血友病因子(vWF)、纤维蛋白原(Fg)、血栓素B2(TXB2)、纤溶酶原激活物抑制因子1(PAI-1)高于单纯高血压组,组织型纤溶酶原激活物(t-PA)低于单纯高血压组,差异有统计学意义(P<0.05)。治疗前对照组和试验组患者CD_(62p)、CD_(63)、vWF、Fg、TXB_2、t-PA、PAI-1比较,差异无统计学意义(P>0.05);治疗后试验组患者CD_(62p)、CD_(63)、vWF、Fg、TXB_2、PAI-1低于对照组,t-PA高于对照组,差异有统计学意义(P<0.05)。治疗后,试验组患者CD_(62p)、CD_(63)、vWF、Fg、TXB_2、PAI-1低于治疗前,t-PA高于治疗前,差异有统计学意义(P<0.05);而对照组患者CD_(62p)、CD_(63)、vWF、Fg、TXB_2、t-PA、PAI-1与治疗前比较,差异无统计学意义(P>0.05)。结论 H型高血压患者存在更为严重的血栓前状态,马来酸依那普利叶酸片在有效降低H型高血压患者血压的同时,可以改善患者的血栓前状态,有助于防止心脑血管事件的发生。

Objective To investigate the impact of enalapril maleate folic acid tablets on prethrombotic state in patients with H- type hypertension. Methods From June 2014 to September 2015,126 level- one hypertension patients who received treatment in the First Affiliated Hospital of Nanchang University were selected. According to the serum homocysteine（ Hcy） levels,the included subjects were divided into simple hypertension group（ Hcy 10 μmol/L,n = 35） and H- type hypertension group（ Hcy≥10 μmol / L,n = 91）; H- type hypertension patients were divided into control group（ n = 46） and experiment group（ n = 45） by random number table method. Patients in simple hypertension group and control group were treated with enalapril maleate tablets orally,patients in experiment group were treated with enalapril maleate folic acid tablets orally,and both of them took continuously for six months. Results The platelet a granule membrane glycoprotein（ CD（62p））,platelet lysosome membrane protein（ CD（63））, von willebrand factor（ vWF）, fibrinogen（ Fg）, thromboxane B2（ TXB2）,plasminogen activator inhibitor- 1（ PAI- 1） of patients in H- type hypertension group were significantly higher than those in simple hypertension group, and its tissue- type plasminogen activator（ t- PA） was significantly lower（ P〈 0. 05）. The comparison of CD（62p）,CD（63）,vWF,Fg,TXB2,t- PA and PAI- 1 between patients in control group and experiment group before treatment was not significantly different（ P〉 0. 05）; CD62 p,CD（63）,vWF,Fg,TXB2,and PAI- 1 of patients after treatment in experiment group were significantly lower than those in control group,while t- PA was significantly higher（ P 〈0. 05）. After treatment,CD（62p）,CD（63）,vWF,Fg,TXB2,and PAI- 1 of patients in experiment group were significantly lower than those before treatment, while t- PA was significantly higher（ P〈 0. 05）; while CD（62p）,CD（63）,vWF,Fg,TXB2,t- PA,and PAI- 1 of patients in control group compared with those of patients before treatment were not significantly different（ P〉 0. 05）. Conclusion H- type hypertension patients have presented even more severe prothrombotic state,and enalapril maleate folic acid tablets can effectively reduce the blood pressure of H- type hypertension patients and improve their prethrombotic state at the same time,which helps prevent the occurrence of cardiovascular and cerebrovascular events.