依那普利叶酸片对冠心病患者同型半胱氨酸及心功能的影响

摘要

Objective To observe the therapeutic eficacy of enalapril-folic acid tablets on coronary heart disease patients’s homocysteine and cardiac function. Methods From Jam 2013 to Nov. 2013, 150 patients from our hospital’s inpatient department were included in this research, all patients were highly suspected coronary heart disease, and willing to accept the coronary angiography (CAG) examination. According to the CAG examination, the patients were divided into CAG normal group (group A) and coronary heart disease group, the patients of coronary heart disease group were randomly divided into enalapril-folic acid tablets treatment group (group B) and enalapril treatment group (group C), there are 50 cases in each group. Group A received placebo, B group was treated with enalapril-folic acid tablets, C group was treated with enalapril. Patients with coronary heart disease taked antiplatelet drugs, Lipid-lowering drugs, nitrates, B receptor blockers, with hypertension taking blood pressure medication, with diabetes mellitus taking glucose-lowering drugs. All patients were measured liver function、kidney function and cardiac function on the second day after admission and after treatment for 3 months, 6 months. Results To compare with group A,there were higher levels of Hcy and worse cardiac function of group B and group C (P<0.05);After 6 months treatment ,the Hcy was lower and the cardiac function was promoted in group B (P<0.05). There was no change of Hcy in group C after drug treatment, but the cardiac function was promoted after drug treatment (P<0.05). liver and kidney function had no obvious change after 6 months drug treatment in each group. Conclusion Enalapril-folic acid tablets had the better effect than enalapril in lowing Hcy and promoting cardiac function of coronary heart disease patients.%目的：观察依那普利叶酸片对冠心病患者同型半胱氨酸及心功能的影响。方法选取2013年1月～2013年11月广东省阳江市人民医院收治的入院时高度怀疑冠心病、且愿意接受冠脉造影（CAG）检查、自愿参与研究的患者为研究对象。对入选患者行CAG检查，选取CAG检查正常者作为空白对照组（A组，n=50），将CAG检查诊断为冠心病者随机分为马来酸依那普利叶酸片治疗组（B组，n=50）及依那普利片治疗组(C组，n=50)。A组服用安慰剂，B组服用马来酸依那普利叶酸片，C组服用依那普利片，所有冠心病患者常规服用抗血小板药物、调脂药物、硝酸酯类药物、β-受体阻滞剂，合并高血压者服用降压药，合并糖尿病者服用降糖药物，对所有患者在入院第2 d及服药后3个月、6个月测量血Hcy、肝肾功能及心功能。结果 B、C两组同型半胱氨酸水平明显高于A组（P＜0.05），心功能差于A组（P＜0.05），B组患者服药6个月后同型半胱氨酸水平明显下降（P＜0.05），心功能显著改善（P＜0.05），C组患者服药后同型半胱氨酸水平无明显变化，心功能较未服药时明显改善（P＜0.05），但效果劣于B组服药6个月后。所有患者服药半年后肝肾功能无明显变化。结论依那普利叶酸片与依那普利片对比，可明显降低冠心病患者同型半胱氨酸水平，改善其心功能。