|
|
|
| Efficacy of Eplerenone Combined with Enalapril in the Treatment of Type H Hypertension with Heart Failure and its Effects on NT-proBNP and Hcy |
| LI Liu-wen, BAI Hong-yan, LI Gang-feng |
| Yulin No.2 Hospital, Yulin 719000,Shaanxi |
|
|
|
|
Abstract 【Objective】 To investigate the efficacy of eplerenone combined with enalapril in the treatment of type H hypertension with heart failure and its effects on N-terminal B-type pro-brain natriuretic peptide (NT-proBNP) and homocysteine(Hcy). 【Methods】 From January 2016 to January 2019, 104 patients with H-type hypertension complicated with chronic heart failure in our hospital were selected as the research objects, and they were divided into observation group and control group according to the random number table method, with 52 cases in each group. The control group was treated with eplerenone, while the observation group was treated with enalapril maleate and folic acid tablets on the basis of the control group for 3 months. The clinical efficacy, serum Hcy and NT-proBNP levels before and after treatment, left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), left ventricular ejection fraction (LVEF), NYHA classification and incidence of adverse reactions were compared between the two groups. 【Results】 The clinical effective rate of the observation group was 92.31% (48/52), which was significantly higher than 76.92% (40/52) of the control group (χ 2=4.727,P=0.03<0.05). After treatment, SBP, DBP and serum Hcy, NT-proBNP levels of the two groups were lower than before treatment, and the observation group was significantly lower than the control group, the difference was statistically significant (P<0.05); LVESD and LVEDD of the two groups were lower than those before treatment, and the observation group was significantly lower than the control group; LVEF was higher than that before treatment, and the observation group was significantly higher than the control group; NYHA grade was significantly improved, the differences were statistically significant (P<0.05); no serious adverse reactions occurred in the two groups during the treatment.【Conclusion】 Eplerenone combined with enalapril folic acid has good clinical effect in the treatment of H-type hypertension with chronic heart failure. It can effectively control the blood pressure and reduce the serum NT-proBNP and Hcy levels.
|
|
Received: 05 July 2019
|
|
|
|
|
|
[1] 黄红华. 细胞因子对冠心病的影响及其相关作用机制的研究进展[J].中国当代医药, 2012, 19(19):16-17.
[2] Flierl U, Fraccarollo D, Micka J, et al. The direct factor Xa inhibitor Rivaroxaban reduces platelet activation in congestive heart failure[J].Pharmacol Res,2013, 74:49-55.
[3] 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 慢性心力衰竭诊断治疗指南[J].中华心血管病杂志, 2007, 35(12):1076-1095.
[4] 曲娜,程显枝,郑帅,等.长期饮用马来酸依那普利叶酸片治疗H型高血压伴慢性心力衰竭患者的安全性研究[J].中国当代医药,2016,23(32):136-138.
[5] 邹青, 赵连友, 李雪, 等. 依那普利叶酸片改善 H 型高血压左室肥厚患者的心功能[J].中国循证心血管医学杂志, 2015, 7(2):188-191.
[6] 赵艳梅, 王东旭, 黄翠娟, 等. 血浆同型半胱氨酸、血脂水平和颈动脉粥样硬化对老年高血压患者发生冠心病的影响[J].中国综合临床, 2016, 32(12):1070-1073.
[7] 朱凌峰. 依那普利叶酸片防治 H 型高血压病疗效观察[J].现代中西医结合杂志, 2013, 22(7):737-739.
[8] Fujimura N, Noma K, Hata T, et al. Mineralocorticoid receptor blocker eplerenone improves endothelial function and inhibits Rho-associated kinase activity in patients with hypertension[J].Clin Pharmacol Ther,2012, 91: 289-297.
[9] 张魁, 田文静, 朱云亮, 等. 依那普利治疗老年脑血栓患者的疗效及其对内皮素-1和超氧化物歧化酶水平的影响[J].疑难病杂志, 2016, 15(6):563-566.
[10] 李哲敏, 马桂芹, 安冀坤, 等. 叶酸对H型高血压患者循环内皮祖细胞和颈动脉弹性的影响[J].疑难病杂志, 2016, 15(7):674-677.
[11] 毛华盛.马来酸依那普利叶酸片治疗H型高血压的临床分析[J].中国医药指南, 2013, 11(22):117-118.
[12] 石红梅. 依那普利叶酸治疗 H 型高血压的临床疗效观察[J].现代预防医学, 2012, 39(13):3456-3457.
[13] 王博, 沈滔, 毛蕾, 等. 依那普利叶酸片对伴发 H 型高血压的急性脑梗死患者预后的影响[J].世界临床药物, 2017, 38(10):680-686. |
|
|
|
2021, Vol. 38 
