本文選題：H型高血壓 + 依那普利葉酸片��； 參考：《中華高血壓雜志》2016年04期

【摘要】：目的研究山西地區(qū)H型高血壓人群血清同型半胱氨酸(Hcy)水平分布特征及依那普利葉酸片干預(yù)后的療效。方法對2013年1月至2015年8月在太原、呂梁、陽泉、忻州、運城5個城市入選的成年H型高血壓患者1207例進行比較效果學(xué)研究(CER),分析其血清Hcy水平的分布特征;將入選的H型高血壓患者1207例分為兩組,一組以服用依那普利葉酸片(依葉)為主要降壓治療(依葉組,n=548),另一組服用除依葉外的其他降壓藥(對照組,n=579),觀察兩組治療后3、6、12、18、24個月的血壓、血清Hcy水平及缺血性腦卒中發(fā)生情況。結(jié)果基線資料中,男性血清Hcy水平為22.00(16.15~37.20)μmol/L,女性為19.55(15.09~26.70)μmol/L(P0.05)。按年齡分層,青年(18~45歲)、中年(45~60歲)和老年(60~93歲)組間血清Hcy水平差異無統(tǒng)計學(xué)意義(P0.05)。按城市分層,運城市的血清Hcy水平高于其他城市(P0.05),其他4個城市H型高血壓患者血清Hcy水平差異無統(tǒng)計學(xué)意義(P0.05)。與治療前相比,依葉組治療2年后,血壓水平降低[收縮壓:(128±8)比(149±16)mm Hg,舒張壓:(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]。與治療前相比,對照組治療2年后血壓水平降低[收縮壓:(127±8)比(150±19)mm Hg,舒張壓:(79±8)比(89±13)mm Hg;均P0.05];血清Hcy水平變化無統(tǒng)計學(xué)意義[20.10(15.05~26.35)比20.40(15.56~30.60)μmol/L,P0.05]。治療2年后,兩組在降壓方面差異無統(tǒng)計學(xué)意義(P0.05),但依葉組血清Hcy水平低于對照組(P0.05)。隨訪2年,依葉組缺血性腦卒中事件發(fā)生5例(0.91%),對照組發(fā)生14例(2.42%)(P0.05)。結(jié)論山西地區(qū)H型高血壓患者血清Hcy水平存在性別、地區(qū)差異。依葉治療H型高血壓患者在降Hcy、預(yù)防缺血性腦卒中事件方面具有更好的療效。
[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 鹵16.15 鹵37.20 渭 mol / L in men and 19.55 鹵15.09 鹵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 鹵8 vs 149 鹵16)mm Hg, diastolic blood pressure: 80 鹵9] vs 89 鹵13)mm Hg; all P 0.05; serum Hcy level was also decreased [11.90 鹵8.30 鹵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 鹵8 vs 150 鹵19)mm Hg, diastolic blood pressure: 79 鹵8] vs 89 鹵13)mm Hg; all P 0.05; serum Hcy level was not significantly changed [20.1015.05 鹵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.
【作者單位】： 山西醫(yī)科大學(xué)第一醫(yī)院心內(nèi)科;山西醫(yī)科大學(xué)第一醫(yī)院腎內(nèi)科;
【基金】：山西省衛(wèi)生廳科研課題資助項目(201301069)
【分類號】：R544.1

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