论文部分内容阅读
目的研究依那普利叶酸片对H型高血压左室肥厚患者心血管事件及心功能指标的影响。方法选取2012年9月至2013年9月收入我院的H型高血压左室肥厚患者100例为研究对象,分为治疗组和对照组,每组各50例。对照组口服依那普利,治疗组口服依那普利叶酸片,2组均治疗12个月。治疗前后检测患者血浆同型半胱氨酸(Hcy)水平、心功能及左室射血分数、主要心血管事件发生率及不良反应发生情况。结果治疗前,2组患者收缩压(SBP)、舒张压(DBP)差异无统计学意义(P>0.05),治疗后,2组SBP、DBP均显著降低(P<0.05),且治疗组降压效果更加明显。治疗前,2组患者血浆Hcy水平比较未见统计学差异(P>0.05),治疗后,2组血浆Hcy水平均显著降低(P<0.05),且治疗组降低更加明显。治疗后,治疗组和对照组患者E/A值,分别由0.65±0.09和0.64±0.13上升到0.93±0.14和0.77±0.12,治疗前后,2组E/A值比较差异均有统计学意义(P<0.05);治疗后,与对照组相比,治疗组患者E/A值显著升高,2组相比差异具有统计学意义(P<0.05)。治疗后,治疗组和对照组的左室射血分数(LVEF)值分别由64.64±1.19和65.11±1.47上升到69.43±1.40和66.95±1.38,治疗前后2组LVEF差异具有统计学意义(P<0.05);治疗后,与对照组相比,治疗组LVEF值显著升高,2组相比差异具有统计学意义(P<0.05)。患者随访时间2~12个月,平均随访时间(7.53±3.74)个月。随访过程中,对照组出现7例主要心血管事件,其中4例脑卒中,2例心肌梗死,1例心血管病死亡,无主要心血管事件生存率为86.0%。治疗组共发生3例主要心血管事件,其中2例脑卒中,1例心肌梗死,无主要心血管事件生存率为94.0%。与对照组比较,治疗组无主要心血管事件生存率显著提高,2组相比差异具有统计学意义(P<0.05)。结论依那普利叶酸片降压及降低血浆Hcy、逆转左室肥厚作用更强,心血管事件发生率更低,其疗效显著强于依那普利,有效保护心脏。
Objective To investigate the effects of enalaprol folate tablets on cardiovascular events and cardiac function in Hypertension patients with left ventricular hypertrophy. Methods 100 cases of hypertensive left ventricular hypertrophy in our hospital from September 2012 to September 2013 were selected as study object, divided into treatment group and control group, 50 cases in each group. In the control group, enalapril was orally administered, and enalapril was administered orally in the treatment group. Both groups were treated for 12 months. Before and after treatment, plasma homocysteine (Hcy) level, cardiac function, left ventricular ejection fraction, major cardiovascular events and adverse reactions were detected. Results Before treatment, there were no significant differences in SBP and DBP between the two groups (P> 0.05). After treatment, the SBP and DBP in the two groups were significantly decreased (P <0.05) Pressure effect is more obvious. Before treatment, there was no significant difference in plasma Hcy levels between the two groups (P> 0.05). After treatment, plasma Hcy levels in both groups were significantly decreased (P <0.05), and the treatment group decreased more obviously. After treatment, the E / A values in the treatment group and the control group increased from 0.65 ± 0.09 and 0.64 ± 0.13 to 0.93 ± 0.14 and 0.77 ± 0.12, respectively, and the E / A values of the two groups were statistically significant before and after treatment P <0.05). After treatment, E / A in the treatment group was significantly higher than that in the control group, and the difference was statistically significant (P <0.05). After treatment, the left ventricular ejection fraction (LVEF) in treatment group and control group increased from 64.64 ± 1.19 and 65.11 ± 1.47 to 69.43 ± 1.40 and 66.95 ± 1.38, respectively. There was significant difference in LVEF between the two groups before and after treatment (P < 0.05). After treatment, LVEF in treatment group was significantly higher than that in control group (P <0.05). Patients were followed up for 2 to 12 months with an average follow-up time of (7.53 ± 3.74) months. During follow-up, there were 7 major cardiovascular events in the control group, including 4 stroke, 2 myocardial infarction and 1 cardiovascular death, with no major cardiovascular event survival rate of 86.0%. Three major cardiovascular events occurred in the treatment group, including two in stroke and one in myocardial infarction, with no major cardiovascular event 94.0%. Compared with the control group, there was no significant increase in the survival rate of major cardiovascular events in the treatment group, there was significant difference between the two groups (P <0.05). Conclusions Enalaprol folic acid tablets depressurization and reduce plasma Hcy, the role of reverse left ventricular hypertrophy stronger, lower incidence of cardiovascular events, the effect was significantly stronger than enalapril, effective protection of the heart.