舒降之与赖诺普利对冠心病相关因子HCY的影响

目的：观察冠心病（coronary heart disease,CHD）患者血浆同型半胱氨酸（homocysteine,HCY）水平在舒降之与赖诺普利作用下的变化情况。方法：①选择我科门诊及住院稳定型心绞痛患者385例,抽取空腹静脉血检测HCY。②血浆HCY〉15μmol/L的140例患者随机分为4组：A组常规组：阿司匹林＋硝酸酯类药;B组舒降之组：舒降之（10 mg,1次/d）＋常规治疗。C组赖诺普利组：赖诺普利（5 mg,1次/d）＋常规治疗。D组联合组：舒降之（10 mg,1次/d）＋赖诺普利（5 mg,1次/d）＋常规治疗。治疗4周后再次检测HCY。结果：①385例老年稳定型心绞痛患者中血浆HCY〉15μmol/L者165例,约占42.86%。②A组治疗前后差异无统计学意义（P〉0.05）。B、C、D组治疗后血浆HCY水平显著降低,差异有统计学意义（P〈0.01）。③B组与C组比较差异无统计学意义（P=0.994）。④D组与B、C组比较差异有统计学意义（D组与B组比较,P=0.043;D组与C组比较,P=0.042）。结论：①冠心病患者血浆HCY水平升高;②舒降之与赖诺普利均可降低老年稳定型心绞痛患者血浆HCY水平,且二者具有协同作用。

The Effect of Zocor and Lisinopril on CHD-Related Factor HCY

Objective：To investigate the level of plasma homocysteine（HCY） in patients with CHD before and after treated with zocor and lisinopril.Methods：①With draw the anticoagulative blood from the empty stomach of outpatients and inpatients with stable angina,then measured the level of HCY.There were total 385 cases enrolled in the study.② 140 cases with plasma HCY 15 μmol/l were randomly divided into four groups：Group A,routine group ：aspirin ＋ nitrates;Group B,zocor group：zocor（10 mg,1 time/day） ＋ routine therapy;Group C,lisinopril group：lisinopril（5 mg,1 time/day） ＋ routine therapy;and Group D,alliance group： zocor（10 mg,1 time/ day） ＋ lisinopril（5 mg,1 time/day） ＋ routine therapy.The level of HCY was measured again 4 weeks later.Results： ①Among 385 cases,165 patients whose plasma HCY 15μmol/L,accounted for 42.86%.②The level of plasma HCY in Group A had no statistically significant difference before and after treatment（P0.05）,but it was significantly decreased in all of Group B,C and D,and the differences had extremely statistical significance（P0.01）.③There was no significant difference between Group B and C（P=0.994）;④Compared Group D with B and C,The difference were significant（between group D and B,P=0.043;between group D and C,P=0.042）.Conclusions： ①The level of plasma HCY increased in patients with CHD;②Both zocor and lisinopril could reduce the level of plasma HCY in old patients with stable angina,and furthermore,there was synergistic action between them.