马来酸依那普利叶酸片治疗短暂性脑缺血发作伴H型高血压的临床研究
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篇名: 马来酸依那普利叶酸片治疗短暂性脑缺血发作伴H型高血压的临床研究
TITLE:
摘要: 目的:探讨马来酸依那普利叶酸片治疗短暂性脑缺血发作(TIA)伴H型高血压的临床效果及安全性。方法:选择我院收治的TIA伴H型高血压患者140例,按照入院先后顺序分为观察组和对照组,各70例。对照组患者清晨口服马来酸依那普利片,初始剂量为5~10 mg/d,分1~2次服用,根据血压水平可逐渐增加剂量,最大剂量不超过40 mg/d;观察组患者清晨口服马来酸依那普利叶酸片,初始剂量为每日5 mg/0.4 mg,根据血压水平调整给药剂量至患者耐受。两组患者均治疗12个月。观察两组患者治疗前后的平均动脉压(MAP)和同型半胱氨酸(Hcy)水平,并比较脑血管意外事件发生率和不良反应发生情况。结果:治疗前,两组患者MAP和Hcy水平比较,差异无统计学意义(P>0.05);治疗后,两组患者MAP显著降低,差异有统计学意义(P<0.05),但组间比较,差异无统计学意义(P>0.05);观察组患者Hcy水平显著降低,且显著低于对照组,差异均有统计学意义(P<0.05)。观察组患者脑血管总意外事件发生率显著低于对照组(8.57% vs. 31.43%),差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:马来酸依那普利叶酸片较马来酸依那普利片能明显降低TIA伴H型高血压患者Hcy水平和脑血管意外事件发生率,且安全性较好。
ABSTRACT: OBJECTIVE: To discuss efficacy and safety of Enalapril maleate folic acid tablets in the treatment of transient ischemic attack (TIA) complicating with H type hypertension. METHODS: 140 patients with TIA complicating with H type hypertension selected from our hospital and divided into observation group and control group according to admission order with 70 cases in each group. Control group was given Enalapril maleate tablets orally in the morning, with initial dose of 5-10 mg each day, 1-2 times a day, increasing gradually according to blood pressure, maximal dose no more than 40 mg/d. Observation group was given Enalapril maleate folic acid tablets orally in the morning, with initial dose of 5 mg/0.4 mg each day, increasing gradually according to blood pressure. Both groups received treatment for 12 months. Mean arterial pressure (MAP) and Hcy level of 2 groups were observed before and after treatment, the incidence of cerebrovascular accident and the occurrence of ADR were compared between 2 groups. RESULTS: Before treatment, there was no statistical significance in MAP and Hcy level between 2 groups (P>0.05). After treatment, MAP of 2 groups were decreased significantly, with statistical significance (P<0.05), but there was no statistical significance between 2 groups (P>0.05). Hcy level of observation group was lower than before treatment and control group, with statistical significance (P<0.05).  The incidence of cerebrovascular accident in observation group was significantly lower than in control group (8.57% vs. 31.43%), with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS: Compared with Enalapril maleate tablets, Enalapril maleate folic acid tablets can significantly improve Hcy level of patients with TIA complicating with H type hypertension, and decrease the incidence of cerebrovascular accident with good safety.
期刊: 2017年第28卷第2期
作者: 罗羽慧,封杰,崔坤,梅霞
AUTHORS: LUO Yuhui,FENG Jie,CUI Kun,MEI Xia
关键字: 短暂性脑缺血发作; H型高血压; 马来酸依那普利叶酸片; 平均动脉压;同型半胱氨酸;脑血管意外事件
KEYWORDS: Transient ischemic attack; H type hypertension; Enalapril maleate folic acid tablets; Mean arterial pressure; Homocysteine; Cerebrovascular accident
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