2019 年第 4 期 第 14 卷

依那普利叶酸片治疗H型高血压的效果及对肾功能的影响

Effect of enalapril folic acid tablets on H-type hypertension and renal function

作者：杨锡恒莫新玲

英文作者：

单位：541001桂林医学院附属医院心内科

英文单位：

关键词：H型高血压；依那普利叶酸片；同型半胱氨酸；肾功能

英文关键词：

• 摘要：

• 【摘要】目的    比较马来酸依那普利片与依那普利叶酸片治疗H型高血压的效果及对患者肾功能的影响。方法    选取2016年1月至2018年6月在桂林医学院附属医院接受治疗的H型高血压患者120例，根据随机数字表法将其分为对照组和观察组，各60例。对照组患者在改善生活行为基础上口服马来酸依那普利片治疗，观察组在改善生活行为基础上口服马来酸依那普利叶酸片治疗，2组均连续治疗6个月。比较2组患者治疗前后收缩压、舒张压和血清同型半胱氨酸（Hcy）、尿素氮、肌酐、胱抑素C水平以及治疗期间不良反应发生率，分析患者治疗前血清Hcy水平与肾功能指标的相关性。结果    治疗前2组患者收缩压、舒张压、血清Hcy、尿素氮、肌酐和胱抑素C水平比较差异均无统计学意义（均P>0.05）；治疗后2组患者上述各项指标的检测值均较治疗前降低，且观察组低于对照组［(133±7)mmHg(1 mmHg=0.133 kPa)比（136±7）mmHg、(83±6)mmHg比（88±6）mmHg、(9.0±1.3)μmol/L比（11.2±1.5）μmol/L、(4.1±1.0)mmol/L比（5.3±1.0）mmol/L、(81±6)μmol/L比（85±7）μmol/L、(0.89±0.19)mg/L比（1.01±0.25）mg/L］，差异均有统计学意义（均P<0.05）。对照组与观察组患者治疗期间不良反应发生率比较差异无统计学意义［5.0%(3/60)比3.3%（2/60），P=1.000］。Pearson分析结果显示，治疗前患者的血清Hcy水平与血清尿素氮、肌酐、胱抑素C水平均呈正相关（r=0.389、0.402、0.531， P=0.018、0.012、<0.001）。结论    依那普利叶酸片可有效治疗H型高血压，无明显的不良反应。该药可能通过降低血清Hcy水平来改善肾功能。

• 【Abstract】Objective    To compare the effects of enalapril maleate tablets and enalapril folic acid tablets on H-type hypertension and renal function. Methods    A total of 120 patients with H-type hypertension in Affiliated Hospital of Guilin Medical College were enrolled from January 2016 to June 2018. They were randomly divided into control group and observation group, with 60 cases in each group. The control group took enalapril maleate tablets and the observation group took enalapril maleate folic acid tablets for 6 months on the basis of improving life behavior. Systolic blood pressure, diastolic blood pressure, levels of serum homocysteine(Hcy), urea nitrogen, creatinine, cystatin C were detected before and after treatment and incidence of adverse reactions were recorded. Correlation between serum Hcy level and renal function indicators was analyzed. Results    There was no significant difference of systolic blood pressure, diastolic blood pressure, serum Hcy level and renal function indexes between groups before treatment(all P>0.05). After treatment, systolic blood pressure, diastolic blood pressure, serum Hcy, urea nitrogen, creatinine and cystatin C significantly decreased and they were lower in observation group than those in control group［(133±7)mmHg vs (136±7)mmHg, (83±6)mmHg vs (88±6)mmHg, (9.0±1.3)μmol/L vs (11.2±1.5)μmol/L, (4.1±1.0)mmol/L vs ( 5.3±1.0)mmol/L, (81±6)μmol/L vs (85±7)μmol/L, (0.89±0.19)mg/L vs (1.01±0.25)mg/L］(all P<0.05). There was no significant difference of incidence of adverse reactions between control group and observation group［5.0%(3/60) vs 3.3%(2/60)］(P=1.000). Pearson analysis showed that serum Hcy level of patients before treatment was positively correlated with urea nitrogen, creatinine and cystatin C(r=0.389, 0.402, 0.531; P=0.018, 0.012, <0.001). Conclusion    Enalapril folic acid tablets can effectively treat H-type hypertension without obvious adverse reactions, and may improve renal function by lowering serum Hcy level.