马来酸依那普利叶酸片对H型高血压冠心病患者PCI治疗后心血管事件发生的影响

Efficacy of enalapril maleate and folic acid tablets on cardiovascular events in patients with type H hypertension and coronary heart disease after percutaneous coronary intervention

目的探讨马来酸依那普利叶酸片对H型高血压冠状动脉粥样硬化性心脏病(冠心病)患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗后主要心血管事件(major adverse cardiovascular event,MACE)发生的影响。方法选取2012年11月至2015年5月在攀钢集团总医院心内科住院行PCI治疗的248例H型高血压冠心病患者,随机被分为治疗组121例(给予马来酸依那普利叶酸片降压)与对照组127例(给予其他降压药物)。所有患者均接受PCI治疗后基本用药,分析患者术后1、6、12个月血同型半胱氨酸(homocysteine,Hcy)浓度与MACE发生率。结果术后6个月治疗组血Hcy浓度低于对照组,差异有统计学意义[(14.34±5.34)μmol/L vs.(18.12±7.31)μmol/L,P<0.05];术后6个月治疗组MACE发生率低于对照组,差异有统计学意义(4.5%vs.7.3%,P<0.05)。术后12个月治疗组血Hcy浓度低于对照,差异有统计学意义[(8.75±3.87)μmol/L vs.(17.68±6.97)μmol/L,P<0.01];术后12个月治疗组MACE发生率低于对照组,差异有统计学意义(6.3%vs.12.9%,P<0.01)。结论马来酸依那普利叶酸片可降低H型高血压冠心病PCI治疗后MACE的发生率。

Objectives To explore the efficacy of enalapril maleate and folic acid tablets on major adverse cardiovasclar events(MACE)in patients with H-type hypertension and coronary heart disease after percutaneous coronary intervention(PCI).Methods Totally248patients with H-type hypertension and coronary heart disease were selected in the Department of Cardiology in Pangang General Hospital of Panzhihua from November2012to May2015.They were randomly divided into treatment group(treated with enalapril maleate and folic acid tablets,n=121)and control group(treated with other antihypertensive drugs,n=127).All the patients received the basic medication after PCI,and con?centration of homocysteine(Hcy)and MACE rate of the patients were analyzed among1,6,and12months after PCI.Results Six months after PCI,concentration of Hcy of treatment group was significantly lower than that of control group[(14.34±5.34)μmol/L vs.(18.12±7.31)μmol/L,P<0.05];MACE rate of treatment group was significantly lower than that of control group(4.5%vs.7.3%,P<0.05).Twelve months after PCI,concentration of Hcy of treatment group was significantly lower than that of control group[(8.75±3.87)μmol/L vs.(17.68±6.97)μmol/L,P<0.01];MACE rate of treatment group was significantly lower than that of control group(6.3%vs.12.9%,P<0.01).Conclusions Enalapril maleate and folic acid tablets can reduce MACE rate in patients with type H hypertension and coronary heart disease after PCI.