鄒玲　閆振明　張磊

【摘要】 目的 探究氯沙坦鉀氫氯噻嗪聯合葉酸片對H型高血壓患者血壓控制及血清同型半胱氨酸（Hcy）、胱抑素C（CysC）水平變化的影響。方法 112例H型高血壓患者， 采用隨機數字表法分為對照組和觀察組， 各56例。對照組予以氯沙坦鉀氫氯噻嗪治療， 觀察組在對照組基礎上予以葉酸片治療。比較兩組治療效果， 治療前后血清Hcy、CysC、β2-微球蛋白（β2-MG）、葉酸及血壓[舒張壓（DBP）、收縮壓（SBP）]水平。結果 觀察組治療總有效率92.86%高于對照組的78.57%， 差異有統(tǒng)計學意義（P<0.05）。治療前， 兩組DBP、SBP水平比較差異無統(tǒng)計學意義（P>0.05）;治療后， 觀察組DBP、SBP均低于對照組， 差異有統(tǒng)計學意義（P<0.05）。治療前， 兩組血清Hcy、CysC、β2-MG、葉酸水平比較差異無統(tǒng)計學意義（P>0.05）;治療后， 觀察組血清Hcy、CysC、β2-MG水平均低于對照組， 葉酸水平高于對照組， 差異有統(tǒng)計學意義（P<0.05）。結論 氯沙坦鉀氫氯噻嗪聯合葉酸片治療H型高血壓患者能有效控制患者血壓， 降低血清Hcy、CysC、β2-MG水平， 提高葉酸水平， 值得臨床推廣。

【關鍵詞】 H型高血壓;氯沙坦鉀氫氯噻嗪;葉酸片

【Abstract】 Objective To investigate the effect of losartan potassium hydrochlorothiazide combined with folic acid tablets on blood pressure control and serum homocysteine （Hcy） and Cystatin C （CysC） level changes in patients with H-type hypertension. Methods A total of 112 patients with H-type hypertension were divided by random number table method into control group and observation group， with 56 cases in each group. The control group was treated with losartan potassium hydrochlorothiazide， and the observation group was treated with folic acid on the basis of the control group. Comparison were made on treatment effect， serum levels of Hcy， CysC， β2-microglobulin （β2-MG）， folic acid and blood pressure [diastolic blood pressure （DBP）， systolic blood pressure （SBP）] before and after treatment between the two groups. Results The observation group had higher total treatment effective rate as 92.86% than 78.57% in the control group， and the difference was statistically significant （P<0.05）. Before treatment， both groups had no statistically significant in DBP and SBP level （P>0.05）. After treatment， the observation group had lower DBP and SBP than the control group， and the difference was statistically significant （P<0.05）. Before treatment， both groups had no statistically significant difference in serum Hcy， CysC， β2-MG and folic acid level （P>0.05）. After treatment， the observation group had lower serum Hcy， CysC and β2-MG level than the control group， and higher folic acid than the control group. Their difference was statistically significant （P<0.05）. Conclusion Combination of losartan potassium hydrochlorothiazide and folic acid can effectively control the blood pressure of patients with H-type hypertension， lower serum Hcy， CysC and β2-MG level， and increase folic acid levels. It is worthy of clinical promotion.

【Key words】 H-type hypertension; Losartan potassium hydrochlorothiazide; Folic acid