|本期目录/Table of Contents|

[1]蔡嵩,郑成,宫海滨,等.依那普利叶酸片治疗伴有高同型半胱氨酸血症原发性高血压卒中患者临床疗效[J].慢性病学杂志,2020,21(01):24-27.
　CAISong *,ZHENGCheng,GONGHai-bin,et al.Clinical efficacy of enalapril folic acid tablets in the treatment of patients with hypertensive stroke accompanied by hyperhomocysteinemia[J].,2020,21(01):24-27.
点击复制

依那普利叶酸片治疗伴有高同型半胱氨酸血症原发性高血压卒中患者临床疗效

《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:
21
期数:
2020年01期
页码:
24-27
栏目:
论　著
出版日期:
2020-01-28

文章信息/Info

Title:
Clinical efficacy of enalapril folic acid tablets in the treatment of patients with hypertensive stroke accompanied by hyperhomocysteinemia
作者:
蔡嵩1; 郑成2; 宫海滨2; 王旭光1; 张强1; 于吉友1; 王平1
1.丰县人民医院，江苏 徐州 221700； 2.徐州市中心医院，江苏 徐州 221009
Author(s):
CAISong * ; ZHENGCheng; GONGHai-bin; WANGXu-guang; ZHANGQiang; YUJi-you; WANGPing
*FengxianPeople’sHospital,Xuzhou22170,Jiangsu，China Correspondingauthor:ZHENGCheng,E-mail:58092542@qq.com
关键词:
依那普利叶酸片; 高同型半胱氨酸血症; 原发性高血压; 卒中; 同型半胱氨酸
Keywords:
Enalapril folic acid tablets;  Hyperhomocysteinemia;  Hypertension;  Stroke;  Homocysteine
分类号:
R544.1
DOI:
-
摘要:
目的 探讨依那普利叶酸片治疗伴有高同型半胱氨酸（Hcy）血症原发性高血压卒中患者临床效果。 方法 选取2017年6月至2017年11月丰县人民医院治疗的伴有高Hcy血症原发性高血压卒中患者120例作为研 究对象，随机分为观察组和对照组，每组60例。观察组采用依那普利叶酸片治疗，对照组采用马来酸依那普利治 疗，疗程均6个月，对比两组患者的血压、Hcy水平、美国国立卫生研究院卒中量表（NIHSS）评分和卒中的复 发率。结果 治疗后，两组患者的收缩压、舒张压均显著降低（P<0.05），组间药物降压效果比较差异无统计学 意义（P>0.05），治疗后观察组Hcy水平（8.59±2.19）μmol/L、NIHSS评分（12.13±5.74）分明显低于对照组 的Hcy水平（15.18±2.06）μmol/L、NIHSS评分（15.92±4.60）分，差异有统计学意义（P<0.05）。随访6个 月，观察组患者卒中的复发率是3.33%，对照组的复发率是5.00%，差异无统计学意义（P>0.05）。两组治疗期 间均无严重不良反应发生，低血压发生率比较差异无统计学意义（P>0.05）。结论 依那普利叶酸片可有效降 低伴有高Hcy血症原发性高血压卒中患者的血Hcy水平，控制血压，改善卒中患者的神经功能，能显著提高临床 疗效，但未观察到降低血Hcy能预防卒中复发的作用。
Abstract:
Objective To analyze the clinical effect of enalapril folic acid tablets in the treatment of pa-tients with hypertensive stroke accompanied by hyperhomocysteinemia. Methods A total of120 pa-tients with hypertensive stroke accompanied by hyperhomocysteinemia who were treated in Fengxian People’s Hospital from June to November 2017 were randomly divided into observation group（n=60） and control group（n=60）. The observation group was treated with enalapril maleate folic acid tab-lets, the control group was treated with enalapril maleate, and the treatment course in the two group were all6 months. The blood pressure, homocysteine（Hcy）concentration, NIHSS score and stroke recurrence rate were compared between the two groups. Results After treatment, the systolic and di-astolic blood pressures of the two groups were significantly decreased（P<0.05）. There was no signifi-cant difference in the antihypertensive effect between the two groups （P>0.05）. The Hcy level （8.59±2.19）μmol/L and NIHSS scores（12.13±5.74）were significantly lower than those of the con-trol group [ Hcy level（15.18±2.06）μmol/L and NIHSS scores（15.92±4.60）], and the differences were statistically significant（P<0.05）. After 6 months of follow-up, the probability of recurrence ofstroke in the observation group was 3.33%, which in the control group was5%, and the difference was not statistically significant（P>0.05）. There was no serious adverse reaction in the two groups, and there was no significant difference in the incidence of low blood pressure between the two groups （P>0.05）. Conclusion Enalapril folic acid tablets can improve the neurological function of stroke pa-tients by reducing blood Hcy levels and controlling blood pressure in patients with hypertensive stroke accompanied by hyperhomocysteinemia. However, blood Hcy reduction can not prevent the recurrence of stroke.

参考文献/References:

[1] 中国高血压防治指南修订委员会.中国高血压防治指南2010[J]. 中华高血压杂志,2011,19(8):701-743. [2] Mao X, Han L. The Relationship of Methylenetetrahydro-folate Reductase Gene C677T Polymorphism and Ischemic Stroke in Chinese Han Population [J]. Ann Clin Labor Sci,2018,48(2):242-247. [3] Huo Y, Li JP, Qin XH,etal. Efficacy of folic acid thera-py in primary prevention of stroke among adults with hy-pertension in China the CSPPT randomized clinical trial [J]. J Am Med Assoc, 2015,313(13):1325-1335. [4] 李建平,卢新政,霍勇,等.伴有高同型半胱氨酸血症原发性高血 压诊断与治疗专家共识[J].中华高血压杂志,2016,8(2):23-28.. [5] 康聚贤,张培,尹少华,等.不同降压药联合叶酸对伴有高同型半 胱氨酸血症原发性高血压急性脑梗死的疗效研究[J].中国卫生标 准管理,2016,7(11):121-122. [6] 王清,吴松笛,职瑾,等.马来酸依那普利叶酸片治疗伴伴有高同 型半胱氨酸血症原发性高血压急性脑梗死患者临床疗效[J].神经 损伤与功能重建,2019,14(3):143-144. [7] 刘峰,于宏亮,王永想.血清hs-CRP、Hcy、TIMP-1水平变化与 急性脑梗死患者NIHSS评分的关联性分析[J].实验与检验医学, 2019,37(1):107-109. [8] Wald DS, Law M，Morris JK. Homocysteine and cardio-vascular disease; evidence on causality from a meta-analy-sis [J]. BMJ, 2002,325(7374):1202-1206.

备注/Memo

备注/Memo:
基金项目：江苏省科技厅临床医学科技专项（BL2012019） 作者简介：蔡嵩，大学本科，副主任医师，研究方向：神经外科 通信作者：郑成，E-mail：58092542@qq.com
更新日期/Last Update: 2020-01-28