叶酸联合依那普利治疗H型老年高血压疗效及对患者血清炎症因子和血管内皮素的影响
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摘要
目的:观察叶酸联合依那普利治疗H型老年高血压的疗效,及对患者血清炎症因子和血管内皮素(ET-1)的影响。方法:120例65岁以上的H型高血压患者随机分为两组各60例。研究组给予马来酸依那普利片联合叶酸片治疗,对照组单用马来酸依那普利片治疗,均连续治疗4周。比较两组患者治疗前后的动态血压和血压变异性,血清C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)的变化。结果:治疗后,两组动态血压、血压变异指数均较前明显降低(P <0. 05),血清CRP、IL-6、TNF-α,以及同型半胱氨酸(Hcy)、ET-1水平也较前显著下降(P <0. 05);且除24hDBP高于对照组(P<0. 05)外,上述各项指标研究组均低于对照组(P <0. 05)。结论:叶酸联合依那普利可显著降低H型老年高血压患者的动态血压和血压变异指数,同时减轻患者机体炎性反应,改善内皮细胞功能。
Objective: To observe the therapeutic effect of folic acid combined with enalapril in the treatment of H-type hypertension in elderly patients and its effect on serum inflammatory factors and endothelin( ET-1). Methods: Totally 120 patients with H-type hypertension over 65 years old in our hospital were randomly divided into two groups. The experimental group was treated with enalapril maleate and folic acid,and the control group was treated with enalapril maleate. Both groups were treated for 4 weeks. Dynamic blood pressure,blood pressure variability,inflammatory factors [C-reactive protein( CRP),tumor necrosis factor-α( TNF-α),interleukin-6( IL-6) ] and ET-1 before and after the treatment in the two groups were compared. Results: After the treatment,the dynamic blood pressure and blood pressure variability index of both groups were significantly lower than those before the treatment( P < 0. 05),and serum CRP,IL-6,TNF-α,homocysteine( Hcy) and ET-1 levels were also significantly lower than those before the treatment( P <0. 05); all the above indexes in the experimental group were lower than those in the control group,except that 24 h DBP in the experimental group was higher than that in the control group( P < 0. 05). Conclusion: Folic acid combined with enalapril can significantly reduce the blood pressure and blood pressure variability index of H-type hypertension in elderly patients,and reduce inflammatory response and improve endothelial cell function in the patients.
Objective: To observe the therapeutic effect of folic acid combined with enalapril in the treatment of H-type hypertension in elderly patients and its effect on serum inflammatory factors and endothelin( ET-1). Methods: Totally 120 patients with H-type hypertension over 65 years old in our hospital were randomly divided into two groups. The experimental group was treated with enalapril maleate and folic acid,and the control group was treated with enalapril maleate. Both groups were treated for 4 weeks. Dynamic blood pressure,blood pressure variability,inflammatory factors [C-reactive protein( CRP),tumor necrosis factor-α( TNF-α),interleukin-6( IL-6) ] and ET-1 before and after the treatment in the two groups were compared. Results: After the treatment,the dynamic blood pressure and blood pressure variability index of both groups were significantly lower than those before the treatment( P < 0. 05),and serum CRP,IL-6,TNF-α,homocysteine( Hcy) and ET-1 levels were also significantly lower than those before the treatment( P <0. 05); all the above indexes in the experimental group were lower than those in the control group,except that 24 h DBP in the experimental group was higher than that in the control group( P < 0. 05). Conclusion: Folic acid combined with enalapril can significantly reduce the blood pressure and blood pressure variability index of H-type hypertension in elderly patients,and reduce inflammatory response and improve endothelial cell function in the patients.
引文
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10张长群,许骥,张娈和,等.原发性高血压患者血清高敏C反应蛋白、脂联素、一氧化氮和内皮素1水平的变化[J].中华高血压杂志,2014,22(11):1078-1080
11吴金花,张海丽,冯丽珍.H型高血压患者血浆ET-1、v WF因子变化的相关研究[J].武警后勤学院学报(医学版),2013,22(5):356-359
12付龙,孙溢晗,张月兰.MTHFR基因C677T多态性与H型高血压合并冠心病患者HCY、冠状动脉病变的关系[J].中国医科大学学报,2015,44(4):351-356
13潘兴丰.温州市区H型高血压流行病学研究及相关危险因素分析[J].中华全科医学,2015,18(12):2018-2019
14杜彪,张杰,谢星星,等.马来酸依那普利叶酸片治疗H型高血压的系统评价[J].中国现代应用药学,2015,32(12):1488-1493
15 Su X,Wang Y,Zhou G,et al.Probucol attenuates ethanol induced liver fibrosis in rats by inhibiting oxidative stress,extracellular matrix protein accumulation and cytokine production[J].Clin Exp Pharmacol Physiol,2014,41(1):73-80
2陈慧,徐群威.依那普利联用叶酸治疗H型高血压的临床疗效及对血管内皮功能的影响[J].中华全科医学,2017,15(5):805-807,867
3吉璐,陈慧,周玉颖,等.血中叶酸,维生素B12及蛋氨酸循环产物与阿尔茨海默病关系的人群研究[J].营养学报,2015,37(3):235-238
4王洲羿,周刚,李钢,等.叶酸和维生素B12联合治疗对血管性痴呆伴H型高血压患者血浆Hcy、炎性因子水平及血管壁内皮功能的影响[J].海南医学院学报,2017,23(5):713-716,720
5《中国高血压基层管理指南》修订委员会.中国高血压基层管理指南(2014年修订版)[J].中华高血压杂志,2015,23(1):24-43
6吴春霖,王镭,李卫兵.临床试验随机化分组及其Stata的实现[J].中国循证医学,2013,13(2):242-244
7张颖,魏简汇,翟保同,等.普罗布考联合依那普利叶酸片对H型高血压患者炎症因子与血浆ET-1的影响[J].重庆医学,2016,45(31):4418-4420
8郑卫峰,王晓阳,张守彦.冠心病患者IVUS-VH下斑块性质与H型高血压的关系[J].中国动脉硬化杂志,2015,23(1):78-82
9康聚贤,张培.早期联合治疗H型高血压急性脑梗死临床效果观察[J].现代医药卫生,2016,32(17):2641-2643
10张长群,许骥,张娈和,等.原发性高血压患者血清高敏C反应蛋白、脂联素、一氧化氮和内皮素1水平的变化[J].中华高血压杂志,2014,22(11):1078-1080
11吴金花,张海丽,冯丽珍.H型高血压患者血浆ET-1、v WF因子变化的相关研究[J].武警后勤学院学报(医学版),2013,22(5):356-359
12付龙,孙溢晗,张月兰.MTHFR基因C677T多态性与H型高血压合并冠心病患者HCY、冠状动脉病变的关系[J].中国医科大学学报,2015,44(4):351-356
13潘兴丰.温州市区H型高血压流行病学研究及相关危险因素分析[J].中华全科医学,2015,18(12):2018-2019
14杜彪,张杰,谢星星,等.马来酸依那普利叶酸片治疗H型高血压的系统评价[J].中国现代应用药学,2015,32(12):1488-1493
15 Su X,Wang Y,Zhou G,et al.Probucol attenuates ethanol induced liver fibrosis in rats by inhibiting oxidative stress,extracellular matrix protein accumulation and cytokine production[J].Clin Exp Pharmacol Physiol,2014,41(1):73-80
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