马来酸依那普利叶酸片治疗短暂性脑缺血发作伴H型高血压的临床研究

发布时间：2018-04-11 08:40

本文选题：短暂性脑缺血发作 + H型高血压　；参考：《中国药房》2017年02期

【摘要】：目的:探讨马来酸依那普利叶酸片治疗短暂性脑缺血发作(TIA)伴H型高血压的临床效果及安全性。方法:选择我院收治的TIA伴H型高血压患者140例,按照入院先后顺序分为观察组和对照组,各70例。对照组患者清晨口服马来酸依那普利片,初始剂量为5~10 mg/d,分1~2次服用,根据血压水平可逐渐增加剂量,最大剂量不超过40 mg/d;观察组患者清晨口服马来酸依那普利叶酸片,初始剂量为每日5 mg/0.4 mg,根据血压水平调整给药剂量至患者耐受。两组患者均治疗12个月。观察两组患者治疗前后的平均动脉压(MAP)和同型半胱氨酸(Hcy)水平,并比较脑血管意外事件发生率和不良反应发生情况。结果:治疗前,两组患者MAP和Hcy水平比较,差异无统计学意义(P0.05);治疗后,两组患者MAP显著降低,差异有统计学意义(P0.05),但组间比较,差异无统计学意义(P0.05);观察组患者Hcy水平显著降低,且显著低于对照组,差异均有统计学意义(P0.05)。观察组患者脑血管总意外事件发生率显著低于对照组(8.57%vs.31.43%),差异有统计学意义(P0.05)。两组患者不良反应发生率比较,差异无统计学意义(P0.05)。结论:马来酸依那普利叶酸片较马来酸依那普利片能明显降低TIA伴H型高血压患者Hcy水平和脑血管意外事件发生率,且安全性较好。
[Abstract]:Objective: to investigate the efficacy and safety of enalapril maleate folic acid tablets in the treatment of TIA with H type hypertension.Methods: 140 TIA patients with H type hypertension were divided into observation group and control group according to the order of admission.The control group took enalapril maleate tablets early in the morning, the initial dose was 5 ~ 10 mg / d, which was divided into 1 dose and 2 times. According to the blood pressure level, the dosage could be increased gradually, the maximum dose was not more than 40 mg / d; the observation group patients took enalapril maleate folic acid tablets in the morning.The initial dose was 5 mg/0.4 mg daily and the dosage was adjusted to patient tolerance according to blood pressure level.Both groups were treated for 12 months.The mean arterial pressure (MAPP) and homocysteine homocysteine (HCH) levels before and after treatment were observed, and the incidence of cerebrovascular accidents and adverse reactions were compared between the two groups.Results: before treatment, there was no significant difference in MAP and Hcy levels between the two groups, but after treatment, the MAP of the two groups decreased significantly (P 0.05), but there was a significant difference between the two groups.The level of Hcy in the observation group was significantly lower than that in the control group (P 0.05).The incidence of total cerebrovascular accidents in the observation group was significantly lower than that in the control group (8.57 vs 31.43), and the difference was statistically significant (P 0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P 0.05).Conclusion: compared with enalapril maleate tablets, folic acid tablets of enalapril maleate can significantly reduce the level of Hcy and the incidence of cerebrovascular accidents in patients with TIA with H type hypertension, and the safety is better than that of enalapril maleate tablets.
【作者单位】：重庆市人民医院心内科;重庆市人民医院药剂科;
【基金】：重庆市医学科研计划项目(No.2011-2-370)
【分类号】：R544.1;R743.31

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