【摘要】：目的：評價(jià)馬來酸依那普利葉酸片、氨氯地平或厄貝沙坦聯(lián)合葉酸用于H型高血壓患者降壓和降同型半胱氨酸（homocysteine，Hcy）的療效和安全性。方法：2011年5月到2013年8月，在桂林地區(qū)，入選51-72歲H型高血壓患者107例，首先服用馬來酸依那普利葉酸片，若無不良反應(yīng)分配到A組（52例）：馬來酸依那普利+葉酸固定復(fù)方制劑（10mg/0.8mg/d），若患者出現(xiàn)不良反應(yīng)，根據(jù)患者病情需要分配到B組（27例）：氨氯地平（5mg/d）+葉酸（0.8mg/d）或C組（28例）：厄貝沙坦（150mg/d）+葉酸（0.8mg/d），連續(xù)治療8周。觀察三組H型高血壓患者的血壓和同型半胱氨酸的變化。結(jié)果：1三組患者在治療第4周、第8周收縮壓、舒張壓均較同組自身基線值降低（P0.05）,[收縮壓：A組：（156.34±12.67）比（134.45±11.57）比（127.39±10.21）mmHg；B組：（155.81±12.78）比（146.92±15.08）比（136.85±11.65）mmHg；C組：（157.24±13.01）比（147.24±14.31）比（135.46±12.39）mmHg，均P0.05。舒張壓：A組：（96.29±12.67）比（90.29±14.16）比（86.23±13.28）mmHg；B組：（97.54±12.13）比（96.52±10.23）比（88.58±14.56）mmHg；C組：（95.45±10.82）比（94.78±14.29）比（87.59±11.26）mmHg，均P0.05]，，第8周至正常水平，但A組要比B、C組降壓效果好。2三組患者在治療第4周、第8周Hcy均較同組自身基線值降低（P0.05），A、C組第8周的Hcy均較同組第4周Hcy降低（P0.05），[A組：（18.81±7.22）比（13.59±6.17）比（11.24±5.57）μmol/L；B組：（18.59±4.29）比（16.47±4.28）比（16.03±4.70）μmol/L；C組：（18.08±5.36）比（14.71±4.62）比（12.41±3.57）μmol/L]，但A組要比B、C組降同型半胱氨酸效果好。結(jié)論：馬來酸依那普利葉酸片對于降低H型高血壓患者近期的血壓和同型半胱氨酸的效果優(yōu)于氨氯地平或厄貝沙坦聯(lián)合葉酸的效果。
[Abstract]:Objective: to evaluate the efficacy and safety of folic acid tablets of enalapril maleate, amlodipine or irbesartan combined with folic acid in lowering blood pressure and lowering homocysteine (homocysteine,Hcy) in patients with type H hypertension. Methods: from May 2011 to August 2013, 107 patients with H type hypertension aged 51-72 years were enrolled in Guilin area. If no adverse reactions were assigned to group A (52 cases): enalapril maleate folic acid fixed compound preparation (10mg/0.8mg/d), if the patient had adverse reactions, Group B (27 cases): amlodipine (5mg/d) folic acid (0.8mg/d) or group C (28 cases): irbesartan (150mg/d) folic acid (0.8mg/d) for 8 weeks. The changes of blood pressure and homocysteine in three groups of patients with H-type hypertension were observed. Results systolic blood pressure and diastolic blood pressure in the three groups were significantly lower than those in the same group at the 4th and 8th weeks (P0.05), [systolic blood pressure: (156.34 鹵12.67) vs (134.45 鹵11.57) vs (127.39 鹵10.21) mmHg;B: (155.81 鹵12.78) vs (146.92 鹵15.08) vs (136.85 鹵11.65) mmHg;C: (157.24 鹵13.01) vs (147.24 鹵14.31) vs (135.46 鹵12.39) mmHg, P 0.05]. Diastolic blood pressure: group A: (96.29 鹵12.67) vs (90.29 鹵14.16) vs (86.23 鹵13.28) mmHg;B: (97.54 鹵12.13) vs (96.52 鹵10.23) vs (88.58 鹵14.56) mmHg;C: (95.45 鹵10.82) vs (94.78 鹵14.29) vs (87.59 鹵11.26) mmHg,. 絎

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