CAJ | 학술논문

目的评价马来酸依那普利加用叶酸用于原发性高血压患者降压和降同型半胱氨酸的疗效.方法采用随机、开放、平行对照的临床研究设计,在一农村社区选择原发性高血压患者,随机分配到3个治疗组中,分别接受对照组(依那普利10 mg)、叶酸低剂量组(依那普利10 mg+叶酸0.4 mg)和高剂量组(依那普利10 mg+叶酸0.8 mg)治疗,每日1次,连续治疗8周.治疗前及治疗后第2、4、6、8周末进行随访,测量坐位血压,并测定给药前、给药后第4周和第8周3个不同时点的血浆同型半胱氨酸(Hcy)水平.试验开始前和结束时进行实验室检查.结果 273例原发性高血压患者进入随机试验.采用意向性分析(ITT).叶酸低剂量组和高剂量组降Hcy和降压的有效率分别为15.2%和17.1%,均显著优于依那普利组(3.8%);叶酸低剂量组和高剂量组降低Hcy或血压的有效率分别为70.9%和58.5%,亦均显著高于依那普利组(43.8%).两个叶酸组降Hcy疗效均显著优于依那普利组(均P<0.05),三组降压疗效无显著差别.结论依那普利联合使用叶酸可用于降低原发性高血压患者的血压和血浆Hcy水平.
목적 평개마래산의나보리가용협산용우원발성고혈압환자강압화강동형반광안산적료효.방법 채용수궤、개방、평행대조적림상연구설계,재일농촌사구선택원발성고혈압환자,수궤분배도3개치료조중,분별접수대조조(의나보리10 mg)、협산저제량조(의나보리10 mg+협산0.4 mg)화고제량조(의나보리10 mg+협산0.8 mg)치료,매일1차,련속치료8주.치료전급치료후제2、4、6、8주말진행수방,측량좌위혈압,병측정급약전、급약후제4주화제8주3개불동시점적혈장동형반광안산(Hcy)수평.시험개시전화결속시진행실험실검사.결과 273례원발성고혈압환자진입수궤시험.채용의향성분석(ITT).협산저제량조화고제량조강Hcy화강압적유효솔분별위15.2%화17.1%,균현저우우의나보리조(3.8%);협산저제량조화고제량조강저Hcy혹혈압적유효솔분별위70.9%화58.5%,역균현저고우의나보리조(43.8%).량개협산조강Hcy료효균현저우우의나보리조(균P<0.05),삼조강압료효무현저차별.결론 의나보리연합사용협산가용우강저원발성고혈압환자적혈압화혈장Hcy수평.
Objective To investigate the efficacy of enalapril combined with folic acid in lowering both blood pressure and plasma total homocysteine (Hcy) in essential hypertensive patients. Methods A randomized, community-based clinical trial was conducted. Subjects with hypertension were randomly assigned to one of three treatment groups:enalapril 10 mg/d alone (control), enalapril 10 mg plus folio acid 0.4 mg daily (low-dose group) and enalapril 10 mg combined with folic acid 0. 8 mg daily (high-dose group) for a total of 8 weeks. Resting blood pressures of all subjects was measured at baseline, 2nd, 4th, 6th and 8th week of therapy. Plasma Hcy levels were measured at baseline, 4th week and the end of study. Results A total of 273 hypertensive patients were enrolled. All analyses were pedormed according to the intention to treat. Compared with control group, both low- and high-dose group had significantly a greater efficacy in lowering both blood pressure and plasma Hcy level, orin lowering either blood pressure or plasma Hcy level, or in lowering Hcy leveL The proportion of subjects showing a marked reduction in both blood pressure and plasma homocysteine in control group, low-dose group and high-dose group were 3.8%, 15.2% and 17. 1% respectively; the priportion of subjects showing a marked reduction in either blood pressure or plasma homocystoine in contnol group, low-close group and high-dose group were 43. 8%, 70. 9% and 58. 5% respectively. Effect upon blood pressure lowering was not significantly different among these three regimens. Conclusion As compared to enalapril alone, enalapril combined with folio acid showed a better efficacy in reducing both blood pressure and plasma Hcy level in hypertensive subjects.