本文選題：短暫性腦缺血發(fā)作 + H型高血壓��； 參考：《中國(guó)藥房》2017年02期

【摘要】：目的:探討馬來(lái)酸依那普利葉酸片治療短暫性腦缺血發(fā)作(TIA)伴H型高血壓的臨床效果及安全性。方法:選擇我院收治的TIA伴H型高血壓患者140例,按照入院先后順序分為觀察組和對(duì)照組,各70例。對(duì)照組患者清晨口服馬來(lái)酸依那普利片,初始劑量為5~10 mg/d,分1~2次服用,根據(jù)血壓水平可逐漸增加劑量,最大劑量不超過(guò)40 mg/d;觀察組患者清晨口服馬來(lái)酸依那普利葉酸片,初始劑量為每日5 mg/0.4 mg,根據(jù)血壓水平調(diào)整給藥劑量至患者耐受。兩組患者均治療12個(gè)月。觀察兩組患者治療前后的平均動(dòng)脈壓(MAP)和同型半胱氨酸(Hcy)水平,并比較腦血管意外事件發(fā)生率和不良反應(yīng)發(fā)生情況。結(jié)果:治療前,兩組患者M(jìn)AP和Hcy水平比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);治療后,兩組患者M(jìn)AP顯著降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05),但組間比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);觀察組患者Hcy水平顯著降低,且顯著低于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組患者腦血管總意外事件發(fā)生率顯著低于對(duì)照組(8.57%vs.31.43%),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者不良反應(yīng)發(fā)生率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:馬來(lái)酸依那普利葉酸片較馬來(lái)酸依那普利片能明顯降低TIA伴H型高血壓患者Hcy水平和腦血管意外事件發(fā)生率,且安全性較好。
[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.
【作者單位】： 重慶市人民醫(yī)院心內(nèi)科;重慶市人民醫(yī)院藥劑科;
【基金】：重慶市醫(yī)學(xué)科研計(jì)劃項(xiàng)目(No.2011-2-370)
【分類(lèi)號(hào)】：R544.1;R743.31

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