依那普利叶酸片对H型高血压伴血压晨峰患者干预效果研究

Intervention Effect of Enalapril Folic Acid Tablets on H-type Hypertensive Patients with Morning Peak Blood Pressure

目的探讨依那普利叶酸片对H型高血压伴血压晨峰患者血压、同型半胱氨酸(Hcy)水平的影响。方法选取2014年9月—2016年3月于成都市第五人民医院就诊的H型高血压伴血压晨峰现象患者144例为研究对象。将患者随机分为3组,各48例。在常规治疗基础上,A组患者于睡前服用马来酸依那普利叶酸片,B组患者于清晨服用马来酸依那普利叶酸片,C组患者于睡前服用马来酸依那普利片。3组患者均在治疗前及治疗12周后行动态血压监测,检测空腹Hcy水平。结果与治疗前比较,各组患者治疗12周后24 h、日间、夜间及晨起平均收缩压、平均舒张压均下降(P<0.05)。A组晨起平均收缩压降低幅度高于B组,总有效率高于C组(P<0.05)。A组治疗前后血压晨峰降低幅度高于B组、C组,Hcy水平降低幅度高于C组(P<0.05)。结论依那普利叶酸片能有效降低H型高血压伴血压晨峰患者血浆Hcy水平,睡前服药控制血压晨峰的效果优于清晨服药。

Objective To study the effect of enalapril folic acid tablets on morning peak blood pressure,homocysteine in H-type hypertensive patients with morning peak blood pressure. Methods A total of 144 patients with type H hypertension and morning blood pressure peak in the Fifth People's Hospital of Chengdu,from September 2014 to March 2016,were selected as the subjects. Patients were randomly divided into 3 groups,each with 48 cases. On the basis of routine treatment,patients in the A group taken enalapril folic acid tablets before sleeping,B group in the morning,and C group taken enalapril tablets before sleeping. Ambulatory blood pressure and fasting Hcy levels were mearsured before treatment and after treatment for 12 weeks.Results Compared with before treatment,the average systolic blood pressure and diastolic blood pressure were decreased at 24h,day,night and morning after treatment for all the patients in the treatment group( P < 0. 05). In the A group,the average systolic blood pressure was lower in the group than that in the B group,and the total effective rate was higher than that in the C group( P < 0. 05). Before and after treatment in A group,the morning blood pressure peak amplitude was higher than that of B group and C group,the Hcy level was higher than that of group C( P < 0. 05). Conclusion Enalapril folic acid tablets can effectively reduce the level of serum Hcy in patients with H type hypertension with morning blood pressure surge,and the control effect of blood pressure of patients taken before sleeping was better than that in the morning.