本文關(guān)鍵詞：苯磺酸氨氯地平葉酸片治療H型高血壓的臨床價值　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： H型高血壓 血漿同型半胱氨酸 苯磺酸氨氯地平片 葉酸

【摘要】：目的:采用口服苯磺酸氨氯地平葉酸片治療伴有血漿同型半胱氨酸(Homocystine HCY)升高的輕、中度原發(fā)性高血患者,觀察藥物降血壓的同時降低血漿同型半胱氨酸作用的有效性。方法:在安慶社區(qū)選擇輕、中度原發(fā)性高血壓患者,同時檢測其血漿同型半胱氨酸濃度,將濃度大于10μmol/L的患者納入試驗,這類患者所患的高血壓稱之為H型高血壓。試驗采用的新藥通過國家食品藥品監(jiān)督局批準,研究獲得倫理委員會批準,所有患者在入組前均簽署知情同意書。之后將最終入選的120例I級、II級原發(fā)性H型高血壓患者,隨機分為3組:A組:服用苯磺酸氨氯地平葉酸片(5mg/0.4mg)40例;B組:服用苯磺酸氨氯地平葉酸片(5mg/0.8mg)40例;C組:單獨服用苯磺酸氨氯地平片(5mg)40例。每組患者在接受藥物治療的同時服用安慰劑進行陰性對照,即每組患者共服用三種藥物,A組患者在服用藥物的同時服用與B、C組藥物相對應(yīng)的安慰劑,B組服用與A、C組藥物相對應(yīng)的安慰劑,C組服用與A、B組藥物相對應(yīng)的安慰劑。安慰劑與相對應(yīng)藥物外觀、顏色、形狀、氣味、包裝完全相同。每日服藥一次,連續(xù)治療8周。在入組前測量所有患者的血壓、血漿同型半胱氨酸、血清葉酸,并在治療的第2、4、6、8周進行隨訪,記錄血壓、血漿同型半胱氨酸、心率,并記錄不良事件。結(jié)果:最終一共115例患者進入隨機試驗,苯磺酸氨氯地平葉酸片(5mg/0.4mg)組、苯磺酸氨氯地平葉酸片(5mg/0.8mg)組及苯磺酸氨氯地平片(5mg)組降壓同時降同型半胱氨酸的有效率分別為23.08%、26.32%、5.26%。兩種配比的苯磺酸氨氯地平葉酸片組降壓同時降血漿同型半管那有效性均顯著優(yōu)于苯磺酸氨氯地平組。A、B、C三組降壓有效率分別為51.28%、55.26%、47.36%,降壓效果三組之間無明顯統(tǒng)計學(xué)差異。而三組在降低血漿同型半胱氨酸上存在明顯差異,有效率分別為25.64%、34.21%、7.89%。兩種配比的苯磺酸氨氯地平葉酸片在降血漿同型半胱氨酸上明顯優(yōu)于氨氯地平,而苯磺酸氨氯地平葉酸片(葉酸高劑量組)降血漿同型半胱氨酸效果優(yōu)于葉酸低劑量組。結(jié)論:采用苯磺酸氨氯地平葉酸片治療伴血漿同型半胱氨酸升高的原發(fā)型輕、中度高血壓患者,復(fù)方制劑在降壓方面不僅不低于氨氯地平單藥效果,而且可以同時降低血漿同型半胱氨酸,同時降低兩種心腦血管疾病危險因素,大大提高H型高血壓患者的預(yù)后,為治療H型高血壓提供新選擇。
[Abstract]:Objective: To observe the efficacy of amlodipine besylate in the treatment of mild and moderate primary high blood plasma with elevated plasma Homocystine HCY level, and observe the effect of drug lowering blood pressure and reducing plasma homocysteine in the treatment of Folic Acid Tablets. Methods: in Anqing community, mild and moderate essential hypertension patients were selected, and plasma homocysteine concentration was detected at the same time. Patients with a concentration of more than 10 mu mol/L were included in the trial. Hypertension in these patients was called H hypertension. The new drug was approved by the State Food and drug administration, and approved by the ethics committee. All patients signed the informed consent before entering the group. 120 cases of grade I, II grade of primary hypertension patients with type H after the final selection, were randomly divided into 3 groups: group A: Amlodipine Besylate Folic Acid Tablets (5mg/0.4mg) 40 cases; group B: Amlodipine Besylate Folic Acid Tablets (5mg/0.8mg) 40 cases; group C: taking Amlodipine Besylate Tablets alone (5mg) in 40 cases. Patients in each group received drug treatment and placebo for the negative control, i.e. each patients were taking three drugs, A group of patients taking drugs at the same time taking with B and C groups corresponding to the placebo group B took A and C group and placebo group taking drugs, C and A, should be relative to the B group of drug placebo. The placebo was exactly the same as the appearance, color, shape, smell and packaging of the corresponding drug. Take the medicine once a day for 8 weeks. Blood pressure, plasma homocysteine and serum folic acid were measured before admission. The patients were followed up for second, fourth, sixth and 8 weeks after treatment. Blood pressure, plasma homocysteine and heart rate were recorded, and adverse events were recorded. Results: a total of 115 patients were entered in randomized trials, amlodipine besylate Folic Acid Tablets (5mg/0.4mg) group, amlodipine group and Folic Acid Tablets (5mg/0.8mg) Amlodipine Besylate Tablets (5mg) group the blood pressure and homocysteine lowering the efficiency were 23.08%, 26.32%, 5.26%. The efficacy of two kinds of amlodipine benzoate Folic Acid Tablets group was significantly better than that of amlodipine sulfonic acid group. The three groups of A, B and C were 51.28%, 55.26% and 47.36% respectively. There was no significant difference between the three groups. There were significant differences between the three groups in reducing plasma homocysteine, and the effective rates were 25.64%, 34.21% and 7.89%, respectively. The two proportions of Folic Acid Tablets, amlodipine besylate, were superior to amlodipine in lowering plasma homocysteine, while amlodipine besylate in Folic Acid Tablets group was superior to folate in low dose group. Conclusion: the amlodipine treatment with Folic Acid Tablets plasma homocysteine primary mild and moderate hypertension, antihypertensive compound preparation in respect not only lower than amlodipine monotherapy effect, but also can reduce the plasma homocysteine, while reducing the two kinds of risk factors of cardiovascular disease and improve prognosis of patients H type hypertension, providing new options for the treatment of H type hypertension.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R544.1

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