依那普利叶酸片治疗脑梗死伴H型高血压患者的效果

Effect of Enalapril Folic Acid Tablets on Patients with Cerebral Infarction and H-type Hypertension

目的探讨依那普利叶酸片治疗急性脑梗死合并H型高血压患者的疗效及对患者血浆同型半胱氨酸(Hcy)、NIHSS、ADL、m RS水平的影响。方法选取2018年6月-2019年12月广州市白云区妇幼保健院收治的伴有H型高血压的急性脑梗死患者127例作为研究对象,按照随机数字表法分为常规治疗组(32例)、叶酸片组(33例)、依那普利组(31例)、依那普利叶酸片组(31例)。常规治疗组予以阿司匹林肠溶片联合苯磺酸氨氯地平片治疗,在常规治疗组基础上,依那普利组予以马来酸依那普利片治疗,叶酸片组予以叶酸片治疗,依那普利叶酸组予以马来酸依那普利叶酸片治疗,比较四组治疗前后神经功能缺损程度、日常生活能力、神经功能恢复情况及Hcy水平。结果治疗后2周、1个月、3个月,依那普利叶酸组NIHSS评分、mRS评分均低于叶酸片组、依那普利组、常规治疗组,ADL评分均高于叶酸片组、依那普利组、常规治疗组,差异有统计学意义(P<0.05);而叶酸片组、依那普利组、常规治疗组NIHSS评分、ADL评分、mRS评分比较,差异无统计学意义(P>0.05)。依那普利叶酸组Hcy水平低于叶酸片组、依那普利组、常规治疗组,差异有统计学意义(P<0.05)。结论依那普利叶酸片可有效降低急性脑梗死合并H型高血压患者血浆Hcy水平,改善其临床症状及预后,提高日常生活能力。

Objective To investigate the efficacy of enalapril folic acid tablets in the treatment of acute cerebral infarction patients with H-type hypertension and its effect on plasma homocysteine(Hcy),NIHSS,ADL and mRS levels.Methods 127 patients with acute cerebral infarction with H-type hypertension who were admitted to the Guangzhou Baiyun District Maternity and Child Health Hospital from June 2018 to December 2019 were selected as the research objects.According to the random number table,they were divided into conventional treatment group(32 cases),folic acid tablets group(33 cases),enalapril group(31 cases),and enalapril folic acid tablets group(31 cases).The conventional treatment group was treated with aspirin enteric-coated tablets combined with amlodipine besylate tablets.On the basis of the conventional treatment group,the enalapril group was treated with enalapril maleate tablets,and the folic acid group was treated with folic acid tablets.The nazepril folic acid group was treated with enalapril maleate folic acid tablets,the degree of neurological deficit,ability of daily living,recovery of neurological function and Hcy level were compared among the four groups before and after treatment.Results Two weeks,one month,and three months after treatment,the NIHSS score and mRS score of the enalapril folic acid group were lower than those of the folic acid tablet group,enalapril group,and conventional treatment group.The ADL scores were all higher than the folic acid tablets group,enalapril group,and conventional treatment group,the difference was statistically significant(P<0.05);There was no statistically significant difference in the NIHSS score,ADL score,and mRS score of the folic acid tablet group,enalapril group,and conventional treatment group(P>0.05).The Hcy level of the enalapril folic acid group was lower than that of the folic acid tablet group,enalapril group,and conventional treatment group,the difference was statistically significant(P<0.05).Conclusion Enalapril folic acid tablets can effectively reduce the plasma Hcy level in patients with acute cerebral infarction and H-type hypertension,improve their clinical symptoms and prognosis,and improve the ability of daily living.