依那普利叶酸片对山西地区H型高血压人群干预后疗效观察

发布时间：2018-06-18 03:01

本文选题：H型高血压 + 依那普利叶酸片　；参考：《中华高血压杂志》2016年04期

【摘要】：目的研究山西地区H型高血压人群血清同型半胱氨酸(Hcy)水平分布特征及依那普利叶酸片干预后的疗效。方法对2013年1月至2015年8月在太原、吕梁、阳泉、忻州、运城5个城市入选的成年H型高血压患者1207例进行比较效果学研究(CER),分析其血清Hcy水平的分布特征;将入选的H型高血压患者1207例分为两组,一组以服用依那普利叶酸片(依叶)为主要降压治疗(依叶组,n=548),另一组服用除依叶外的其他降压药(对照组,n=579),观察两组治疗后3、6、12、18、24个月的血压、血清Hcy水平及缺血性脑卒中发生情况。结果基线资料中,男性血清Hcy水平为22.00(16.15~37.20)μmol/L,女性为19.55(15.09~26.70)μmol/L(P0.05)。按年龄分层,青年(18~45岁)、中年(45~60岁)和老年(60~93岁)组间血清Hcy水平差异无统计学意义(P0.05)。按城市分层,运城市的血清Hcy水平高于其他城市(P0.05),其他4个城市H型高血压患者血清Hcy水平差异无统计学意义(P0.05)。与治疗前相比,依叶组治疗2年后,血压水平降低[收缩压:(128±8)比(149±16)mm Hg,舒张压:(80±9)比(89±13)mm Hg;均P0.05];血清Hcy水平也降低[11.90(8.30~15.05)比21.70(16.21~34.48)μmol/L,P0.05]。与治疗前相比,对照组治疗2年后血压水平降低[收缩压:(127±8)比(150±19)mm Hg,舒张压:(79±8)比(89±13)mm Hg;均P0.05];血清Hcy水平变化无统计学意义[20.10(15.05~26.35)比20.40(15.56~30.60)μmol/L,P0.05]。治疗2年后,两组在降压方面差异无统计学意义(P0.05),但依叶组血清Hcy水平低于对照组(P0.05)。随访2年,依叶组缺血性脑卒中事件发生5例(0.91%),对照组发生14例(2.42%)(P0.05)。结论山西地区H型高血压患者血清Hcy水平存在性别、地区差异。依叶治疗H型高血压患者在降Hcy、预防缺血性脑卒中事件方面具有更好的疗效。
[Abstract]:Objective to study the distribution of serum homocysteine (HCH) levels in patients with H-type hypertension in Shanxi area and the therapeutic effect of enalapril folic acid tablets. Methods from January 2013 to August 2015, 1207 adult patients with H type hypertension in Taiyuan, Lv Liang, Yangquan, Xinzhou and Yuncheng were studied by comparative effect and the distribution characteristics of serum homocysteine were analyzed. 1207 patients with H type hypertension were divided into two groups. One group was treated with enalapril folic acid tablets as the main hypotensive therapy (Eyeye group) 548g, and the other group took other antihypertensive drugs (control group, 579). The blood pressure of the two groups was observed for 24 months after treatment. Serum Hcy level and the incidence of ischemic stroke. Results the baseline data showed that the serum Hcy level was 22.00 卤16.15 卤37.20 渭 mol / L in men and 19.55 卤15.09 卤26.70 渭 mol / L in women (P < 0.05). According to age, there was no significant difference in serum Hcy levels between the two groups (18 ~ 45 years old, 45 ~ 60 years old) and 60 ~ 93 years old group (P < 0.05). According to the urban stratification, the level of serum Hcy in Yuncheng was higher than that in other cities (P 0.05), but there was no significant difference in serum Hcy in patients with H type hypertension in the other four cities. After 2 years of treatment, the blood pressure in the leaf dependent group was lower than that before treatment [systolic blood pressure: 128 卤8 vs 149 卤16)mm Hg, diastolic blood pressure: 80 卤9] vs 89 卤13)mm Hg; all P 0.05; serum Hcy level was also decreased [11.90 卤8.30 卤15.05] vs 21.7016.2134.48 渭 mol / L (P0.05). Compared with before treatment, the blood pressure level of the control group decreased after 2 years of treatment [systolic blood pressure: 127 卤8 vs 150 卤19)mm Hg, diastolic blood pressure: 79 卤8] vs 89 卤13)mm Hg; all P 0.05; serum Hcy level was not significantly changed [20.1015.05 卤26.35] vs 20.4015.5630.60 渭 mol / L (P0.05). After 2 years of treatment, there was no significant difference in hypotension between the two groups, but the serum Hcy level in the leaf dependent group was lower than that in the control group (P 0.05). Following up for 2 years, 5 cases of ischemic stroke occurred in the Ischemic stroke group and 14 cases in the control group. Conclusion there are sex and regional differences in serum Hcy levels in patients with H-type hypertension in Shanxi. Treatment of H-type hypertension by leaf therapy has better effect in reducing Hcyand preventing ischemic stroke events.
【作者单位】：山西医科大学第一医院心内科;山西医科大学第一医院肾内科;
【基金】：山西省卫生厅科研课题资助项目(201301069)
【分类号】：R544.1

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