马来酸依那普利叶酸片治疗老年H型高血压急性脑梗死疗效及对SAA LP(a) NT-proBNP Hcy水平的影响

doi:10.3969/j.issn.1006-6233.2021.10.032

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摘要 目的:观察马来酸依那普利叶酸片治疗老年H型高血压急性脑梗死(ACI)疗效Z及对血清淀粉样物质A(Serum amyloid SAA)、溶血磷脂酸[lysophosphatidic acid LP(a)]、N端前脑钠肽(N-terminal pro-B-type natriuretic peptide NT-proBNP)、同型半胱安酸(homocysteine Hcy)水平的影响。方法:选取2018年10月至2020年10月我院收治的153例老年H型高血压ACI患者作为观察对象,按照简单随机数字表法将其分为观察组(n=79)与对照组(n=74)。对照组患者给予常规治疗,观察组患者在对照组基础上增加马来酸依那普利叶酸片。比较两组患者临床疗效,观察治疗前、治疗3个月后两组患者血压、血清相关指标[SAA、LP(a)、NT-proBNP、Hcy]、认知功能[简易精神状态检查量表(Mini-Mental State Examination MMSE)]、神经功能[神经功能缺损评分(National Institutes of Health Stroke Scale NIHSS评分)]、生活自理能力[Barthel指数评定量表(Barthel IndexBI)]。结果:观察组患者临床总有效率(97.47%)较对照组(89.19%)明显增高,且观察组基本痊愈率明显高于对照组(P<0.05)。治疗3个月后,两组患者血压水平较治疗前显著降低,且观察组降低明显,更接近于正常水平(P<0.05);两组患者SAA、LP(a)、NT-proBNP、Hcy水平及NIHSS评分较治疗前降低,且观察组降低明显(P<0.05);两组患者AMSE及BI评分较治疗前显著增高,且观察组增高明显(P<0.05)。结论:马来酸依那普利叶酸片在改善老年H型高血压ACI患者血压水平,降低SAA、LP(a)、NT-proBNP、Hcy水平,改善神经功能,提高认识功能及生活自理能力中效果显著。

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	曾玉虹
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关键词 ：急性脑梗死, H型高血压, 马来酸依那普利叶酸片, 疗效

Abstract：Objective: To observe the efficacy of enalapril maleate folic acid tablets in the treatment of elderly H-type hypertension with acute cerebral infarction (ACI) and the influence on serum amyloid A (SAA), lysophosphatidic acid [LP(a)], N-terminal pro-B-type natriuretic peptide (NT-proBNP) and homocysteine (Hcy). Methods: Totally 153 elderly patients with H-type hypertension complicated with ACI treated in our hospital between October 2018 and October 2020 were selected as observation subjects, and they were classified into observation group (n=79) and control group (n=74) according to the random number table method. Patients in the control group were given conventional therapy, and patients in the observation group were additionally treated with enalapril maleate folic acid tablets based on the control group. The clinical efficacy of patients was compared, and the blood pressure, serum-related indexes [SAA, LP(a), NT-proBNP, Hcy], cognitive function [Mini-Mental State Examination (MMSE)], neurological function [National Institutes of Health Stroke Scale (NIHSS)] and self-care ability of daily living [Barthel Index (BI)] were observed in the two groups before treatment and 3 months after treatment. Results: The total clinical effective rate was significantly increased in observation group compared with that in control group (97.47% vs 89.19%), and the basic recovery rate was significantly higher than that in control group (P<0.05). 3 months after treatment, the blood pressure level of the two groups was obviously reduced compared to before treatment, and the reduction was more significant in observation group, and was closer to the normal level (P<0.05). The levels of SAA, LP(a), NT-proBNP and Hcy and score of NIHSS in both groups were lower than those before treatment, and the decreases in observation group were more obvious (P<0.05). The scores of AMSE and BI were risen in two groups of patientsthan those before treatment, and observation group had marked increases (P<0.05). Conclusion: Enalapril maleate folic acid tablets for elderly H-type hypertension with ACI has a significant effect in improving the blood pressure level, reducing levels of SAA, LP(a), NT-proBNP and Hcy, improving neurological function, and enhancing cognitive function and self-care ability of daily living.

Key words： Acute cerebral infarction H-type hypertension Enalapril maleate folic acid tablets Efficacy

基金资助:海南省卫生健康行业科研项目,(编号:20A200039)

引用本文:

曾玉虹, 肖音, 陈琳. 马来酸依那普利叶酸片治疗老年H型高血压急性脑梗死疗效及对SAA LP(a) NT-proBNP Hcy水平的影响[J]. 河北医学, 2021, 27(10): 1729-1733.
ZENG Yuhong, XIAO Yin, CHEN Lin. Efficacy of Enalapril Maleate Folic Acid Tablets in the Treatment of Elderly H-Type Hypertension with Acute Cerebral Infarction and Its Influence on Levels of SAA LP(a) NT-ProBNP and Hcy. HeBei Med, 2021, 27(10): 1729-1733.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2021.10.032 或 http://www.hbyxzzs.cn/CN/Y2021/V27/I10/1729

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