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目的观察氨氯地平联合马来酸依那普利/叶酸片(依叶片)对H型高血压的疗效,探讨H型高血压患者血清内皮脂肪酶(EL)和脂联素(APN)水平变化与疗效的关系。方法将90例H型高血压患者随机分成氨氯地平组30例,依叶组30例,氨氯地平+依叶组30例,分别予以口服氨氯地平片、依叶片、氨氯地平片+依叶片治疗6个月,另选择30例健康人作为对照组。观察用药前后各组患者的血压,血清EL、APN及血浆同型半胱氨酸(Hcy)水平。结果 H型高血压患者治疗前血清EL水平显著高于对照组,血清APN水平显著低于对照组,差异均有统计学意义(P均<0.01);治疗6个月后,氨氯地平组、依叶组和氨氯地平+依叶组患者血压均得到有效控制,血清EL水平显著降低,血清APN水平显著升高(P均<0.01),但氨氯地平+依叶组均优于氨氯地平组和依叶组(P均<0.05)。结论氨氯地平、依叶片及氨氯地平联合依叶片均能有效控制血压,降低血清EL含量和升高APN含量,但氨氯地平+依叶片效果更明显,提示EL和APN参与了H型高血压的发生、发展,可以作为判断H型高血压严重程度的指标。
Objective To observe the effect of amlodipine combined with enalapril maleate / folic acid tablets on Hypertension and to explore the changes of serum lipoprotein (EL) and adiponectin (APN) in patients with Hypertension Relationship with the effect. Methods Ninety Hypertensive patients were randomly divided into amlodipine group (n = 30), amlodipine group (n = 30), amlodipine + yiye group (n = 30) According to the leaf treatment for 6 months, another 30 healthy people as the control group. Blood pressure, serum EL, APN and plasma homocysteine (Hcy) levels were observed before and after treatment. Results The level of serum EL before treatment in Hypertensive patients was significantly higher than that in control group, and the serum APN level was significantly lower than that in control group (all P <0.01). After 6 months of treatment, The blood pressure of patients with YE and Amlodipine + YE group was effectively controlled, serum EL level decreased significantly and serum APN level increased significantly (all P <0.01), but Amlodipine + YE group was better than Ammonium Hepatic group and YE group (all P <0.05). Conclusion Combination of amlodipine, vinorelbine and amlodipine can effectively control blood pressure, reduce serum EL content and increase APN content, but amlodipine + vasodilator effect is more obvious, suggesting EL and APN are involved in H type high The occurrence and development of blood pressure can be used as an indicator to judge the severity of Hypertension.