不同时间服用依那普利叶酸片对高龄H型高血压患者昼夜节律及同型半胱氨酸水平的影响

Effects of taking enalapril folic acid tablets at different times on circadian rhythm and homocysteine levels in elderly patients with H-type hypertension

目的探讨在不同时间段服用依那普利叶酸片对80岁以上高血压患者血压昼夜节律及同型半胱氨酸水平(Hcy)的影响。方法入选2015年6月至2017年6月于沧州市中心医院心血管内科门诊就诊的102例非杓型高血压患者,随机分为晨起服药组和夜间服药组,分别于每日8:00和20:00服用依那普利叶酸片,在治疗前和治疗2周后进行动态血压监测,比较服药前后血压昼夜节律的变化以及对血浆Hcy水平的影响。结果与晨起服药相比,夜间服用依那普利叶酸片具有同样良好的降压效果(P>0.05)。与晨起服药相比,夜间服用依那普利叶酸片能有效改善高龄老年患者血压的非杓型血压节律,杓型血压所占的比例分别为53.6%、17.3%(P<0.05)。治疗后,晨起服药组与夜间服药组的Hcy水平(16.31±1.74μmol/L vs.17.13±2.31μmol/L)比较,无显著统计学差异(P>0.05)。结论对于高龄老年H型高血压患者,夜间服用依那普利叶酸片同样可以有效控制血压,降低Hcy水平,纠正非杓型血压节律。

Objective To investigate the effects of taking enalapril folic acid tablets on blood pressure circadian rhythm and homocysteine(Hcy)levels in patients with hypertension over 80 years of age at different time periods.Methods One hundred and twenty patients with non-hypertensive hypertension who were admitted to the Clinic Central Hospital outpatient clinic from June 2015 to June 2017 were randomly divided into the morning medication group and the night medication group.Enalapril folic acid tablets were taken at 8:00 and 20:00 daily,and ambulatory blood pressure monitoring was performed before and after 2 weeks of treatment to compare changes in blood pressure circadian rhythm before and after taking the drug and its effect on plasma Hcy levels.Results Taking enalapril folic acid tablets at night had the same good antihypertensive effect as taking morning pills(P>0.05).Compared with morning medication,taking enalapril folic acid tablets at night can effectively improve the non-arytenotropic blood pressure rhythm of elderly patients,with arytenotropic blood pressure accounting for 53.6%and 17.3%respectively(P<0.05).After treatment,there was no significant difference in Hcy level between the morning and night groups(16.31±1.74 mol/L vs.17.13±2.31 mol/L)(P>0.05).Conclusion For elderly patients with H-type hypertension,taking Enalapril Folic Acid tablets at night can also effectively control blood pressure,reduce Hcy level and correct the rhythm of non-dipper blood pressure.