依那普利叶酸片治疗老年H型高血压临床评价

Clinical Evaluation of Enalapril Maleate and Folic Acid Tablets in Treating Elderly Patients with H-Type Hypertension

目的探讨依那普利叶酸片对老年H型高血压患者血压、血压变异性及脑血管事件的影响。方法选择老年H型高血压患者50例,随机分为对照组(服用依那普利片)和试验组(服用依那普利叶酸片),各25例。采用24 h动态血压监测方法测定治疗前及治疗后的24 h收缩压(SBP)、舒张压(DBP),以及两者昼夜标准差,同时测定治疗前后血浆同型半胱氨酸(Hcy)水平,并统计在此期间发生脑血管事件患者的例数。结果试验组血浆Hcy水平、24 h收缩压标准差(24 h SSD)、白昼收缩压标准差(dSSD)及夜间收缩压标准差(nSSD)、24 h舒张压标准差(24 h DSD)、白昼舒张压标准差(dDSD)和夜间舒张压标准差(nDSD)较治疗前均有下降(P<0.05);对照组24 h SSD,dSSD,nSSD,24 h DSD,dDSD,nDSD及Hcy水平均较治疗前虽有下降趋势,但差异无统计学意义(P>0.05);两组的24 h mSBP和24 h mDBP均较治疗前下降明显(P<0.05);试验组脑血管事件发生例数明显少于对照组,差异有统计学意义(P<0.05)。结论依那普利叶酸片能明显降低老年H型高血压患者的血浆Hcy水平及收缩压变异性,可更好地预防脑血管事件。

Objective To investigate the clinical effect of enalapril maleate and folic acid tablets in treating elderly patients with H-type hypertension. Methods Totally 50 elderly patients with H-type hypertension were randomly divided into the experimental group and the control group,25 cases in each group. The control group was treated with enalapril maleate tablets,while the experimental group was treated with enalapril maleate and folic acid tablets. Before and after treatment,24 h SBP,DBP,24 h SSD,dSSD,nSSD,24 h DSD,dDSD,nDSD were detected by 24 h ambulatory blood pressure monitoring method,at the same time,the Hcy levels were measured,and the number of cerebrovascular events during this period were counted. Results The levels of plasma Hcy,24 h SSD,dSSD,nSSD,24 h DSD,dDSD and nDSD in the experimental group were significantly lower than those before treatment（ P〈0. 05）,The levels of plasma Hcy,24 h SSD,dSSD,nSSD,24 h DSD,dDSD and nDSD in the control group were lower than those before treatment,but had no significantly difference（ P〉0. 05）,The 24 h mSBP,24 h mDBP in the two groups were significantly lower than before treat ment（ P〈0. 05）. The incidence of cerebrovascular events in the experimental group was significantly lower than that in the control group（ P〈0. 05）. Conclusion Enalapril maleate and folic acid tablets can significantly reduce the plasma Hcy and systolic blood pressure variability in elderly patients with H-type hypertension,which can better prevent cerebrovascular events.