| 李 毅,郭 勇,苟 华,颜崇平,杨 渊.同型半胱氨酸与H型高血压左室肥厚的相关性及马来酸依那普利叶酸片的干预效果[J].,2019,19(18):3554-3558 |
| 同型半胱氨酸与H型高血压左室肥厚的相关性及马来酸依那普利叶酸片的干预效果 |
| Correlation between Homocysteine and H-type Hypertension Left Ventricular Hypertrophy and Interventional Effects of Enalapril Maleate Folic Acid Tablets |
| 投稿时间：2019-01-08 修订日期：2019-01-31 |
| DOI：10.13241/j.cnki.pmb.2019.18.034 |
| 中文关键词: H型高血压 同型半胱氨酸 马来酸依那普利叶酸片 相关性 疗效 |
| 英文关键词: H-type hypertension Homocysteine Enalapril maleate folic acid tablets Correlation Efficacy |
| 基金项目:四川省卫生厅科研基金项目（151047）；四川省达州市医学科研项目（201507） |
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| 中文摘要: |
| 摘要 目的：探讨同型半胱氨酸（Hcy）与H型高血压左室肥厚的相关性及马来酸依那普利叶酸片的干预效果。方法：选取达州市中心医院于2015年8月-2017年7月收治的450例原发性高血压患者，根据血浆Hcy水平将患者分为Hcy正常组（n=134）和H型高血压组（n=316），比较Hcy正常组、H型高血压组患者超声心动图检测指标的差异，并对Hcy水平与左心室结构改变进行相关性分析。同时将316例H型高血压患者随机分为观察组（n=158）和对照组（n=158），其中对照组患者给予马来酸依那普利片治疗，观察组给予马来酸依那普利叶酸片治疗。两组均连续治疗24个月。分别于治疗前、治疗后6个月、12个月、24个月检测血压、血浆Hcy和左心室质量指数（LVMI）水平，观察脑卒中及药物不良反应发生情况。结果：H型高血压组左室收缩末内径（LVESD）、左室舒张末内径（LVEDD）、左室后壁厚度（LVPWT）、室间隔厚度（IVST）、左心室质量（LVM）、LVMI均较Hcy正常组增大（P<0.01）。血浆Hcy与LVPWT、IVST、LVM及LVMI呈正相关（r=0.652、0.526、0.736、0.786，均P<0.05）；治疗后6个月、12个月、24个月，观察组与对照组的H型高血压患者收缩压（SBP）、舒张压（DBP）水平及观察组Hcy、LVMI均较治疗前降低（P<0.05），且观察组SBP、DBP、Hcy及LVMI均低于同时间点的对照组（P<0.05）。两组均未见严重药物不良反应发生，观察组脑卒中发生4例（2.53%）较对照组12例（7.59%）明显减少，差异有统计学意义（P<0.05）。结论：血浆Hcy水平是影响原发性高血压患者左心室肥厚的危险因素；马来酸依那普利叶酸片干预H型高血压患者后可显著降低血压、血浆Hcy水平，改善患者左心室肥厚程度，降低脑卒中发生率。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the correlation between homocysteine (Hcy) and H-type hypertension left ventricular hypertrophy and the interventional effects of enalapril maleate folic acid tablets. Methods: 450 patients with essential hypertension who were admitted to Dazhou Central Hospital from August 2015 to July 2017 were selected.They were divided into the Hcy normal group (n=134) and the H-type hypertension group (n=316) according to plasma Hcy level. The differences of echocardiographic indicators between Hcy normal group and H-type hypertension group were compared, and the correlation between Hcy level and left ventricular structure was analyzed. 316 cases of H-type hypertension were randomly divided into the observation group (n=158) and the control group (n=158). The control group was given enalapril maleate tablets, the observation group was given enalapril maleate folic acid tablets. The two groups were treated for 24 months. Blood pressure, plasma Hcy and left ventricular mass index (LVMI) levels were measured before treatment, 6 months, 12 months and 24 months after treatment, and the incidence of stroke and adverse drug reactions were observed. Results: The left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), left ventricular posterior wall thickness (LVPWT), ventricular septal thickness (IVST), left ventricular mass (LVM) and LVMI in H-type hypertension group were all higher than those in Hcy normal group (P<0.01). Plasma Hcy was positively correlated with LVPWT, IVST, LVM and LVMI(r=0.652, 0.526, 0.736, 0.786, all P<0.05). 6 months, 12 months and 24 months after treatment, the systolic blood pressure (SBP), diastolic blood pressure (DBP) and Hcy, LVMI in observation group and control group were lower than those before treatment (P<0.05), and the SBP, DBP, Hcy and LVMI in the observation group were lower than the control group at the same time point (P<0.05). There were no serious adverse drug reactions occurred in the two groups, and the incidence of stroke in the observation group was 4 cases (2.53%), which was significantly lower than that in control group 12 cases (7.59%), the difference was statistically significant(P<0.05). Conclusion: The plasma Hcy levels are the risk factors of left ventricular hypertrophy in patients with essential hypertension. Enalapril folic acid maleate tablets can significantly reduce blood pressure and plasma Hcy levels, improve the degree of left ventricular hypertrophy and reduce the incidence of stroke in patients with H-type hypertension. |
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