苯磺酸氨氯地平联合马来酸依那普利叶酸片治疗老年高血压合并高同型半胱氨酸血症的临床观察

Observation of effect of amlodipine besylate combined with enalapril maleate and folic acid tablets on elderly patients with hypertension complicated by hyperhomocysteinemia

目的分析苯磺酸氨氯地平联合马来酸依那普利叶酸片治疗老年高血压合并高同型半胱氨酸血症(HHcy)的临床效果。方法队列研究。抽取2021年1月至2022年9月驻马店市第一人民医院收治的高血压合并HHcy患者88例,按照用药方案将其分为单一组与联合组,每组44例。单一组采用马来酸依那普利叶酸片治疗,联合组采用苯磺酸氨氯地平联合马来酸依那普利叶酸片治疗。比较两组治疗效果及不良反应发生情况。比较两组治疗前后血压、同型半胱氨酸(Hcy)、一氧化氮(NO)、内皮素-1(ET-1)水平。结果联合组治疗总有效率(93.18%,41/44)高于单一组(75.00%,33/44),P<0.05。治疗后,联合组血压、Hcy水平低于单一组(P<0.05)。治疗后,联合组NO水平高于单一组,ET-1水平低于单一组(P<0.05)。联合组不良反应发生率(15.91%,7/44)与单一组(9.09%,4/44)比较差异未见统计学意义(P>0.05)。结论苯磺酸氨氯地平联合马来酸依那普利叶酸片治疗老年高血压合并HHcy患者,能调节血压及Hcy水平,改善血管内皮功能,提高治疗效果,且具有较高安全性。

Objective To analyze the effects of amlodipine besylate combined with enalapril maleate and folic acid tablets on elderly patients with hypertension complicated by hyperhomocysteinemia(HHcy).Methods A total of 88 patients with hypertension complicated by HHcy treated in the First People’s Hospital of Zhumadian from January 2021 to September 2022 were selected for the cohort study.And they were divided into the single group and the combined group according to medicine regiment,with 44 cases in each group.The single group was treated with enalapril maleate and folic acid tablets,while the combined group was treated with amlodipine besylate combined with enalapril maleate and folic acid tablets.The therapeutic effect and incidence of complications were compared between the two groups.The levels of blood pressure,homocysteine(Hcy),nitric oxide(NO)and endothelin(ET-1)were compared between the two groups before and after treatment.Results The total effective rate of the combined group(93.18%,41/44)was higher than that of the single group(75.00%,33/44),P<0.05.After treatment,the levels of blood pressure and Hcy in the combined group were lower than those in the single group(P<0.05).Compared with the single group,NO level in the combined group was higher,and ET-1 level was lower after treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the combined group(15.91%,7/44)and the single group(9.09%,4/44),P>0.05.Conclusions Amlodipine besylate combined with enalapril maleate and folic acid tablets in the treatment of hypertension complicated by HHcy in elderly patients can regulate blood pressure and Hcy level,improve vascular endothelial function,and promote therapeutic effect,with high safety.