邹玲　闫振明　张磊

【摘要】 目的 探究氯沙坦钾氢氯噻嗪联合叶酸片对H型高血压患者血压控制及血清同型半胱氨酸（Hcy）、胱抑素C（CysC）水平变化的影响。方法 112例H型高血压患者， 采用随机数字表法分为对照组和观察组， 各56例。对照组予以氯沙坦钾氢氯噻嗪治疗， 观察组在对照组基础上予以叶酸片治疗。比较两组治疗效果， 治疗前后血清Hcy、CysC、β2-微球蛋白（β2-MG）、叶酸及血压[舒张压（DBP）、收缩压（SBP）]水平。结果 观察組治疗总有效率92.86%高于对照组的78.57%， 差异有统计学意义（P<0.05）。治疗前， 两组DBP、SBP水平比较差异无统计学意义（P>0.05）;治疗后， 观察组DBP、SBP均低于对照组， 差异有统计学意义（P<0.05）。治疗前， 两组血清Hcy、CysC、β2-MG、叶酸水平比较差异无统计学意义（P>0.05）;治疗后， 观察组血清Hcy、CysC、β2-MG水平均低于对照组， 叶酸水平高于对照组， 差异有统计学意义（P<0.05）。结论 氯沙坦钾氢氯噻嗪联合叶酸片治疗H型高血压患者能有效控制患者血压， 降低血清Hcy、CysC、β2-MG水平， 提高叶酸水平， 值得临床推广。

【关键词】 H型高血压;氯沙坦钾氢氯噻嗪;叶酸片

【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