摘要
目的观察综合性康复联合马来酸依那普利叶酸片与盐酸多奈哌齐治疗H型高血压伴轻度认知障碍(MCI)的疗效。方法选取南京市栖霞区医院2023年1月~2024年6月收治的60岁以上H型高血压伴MCI患者59例,采用Excel表随机数表法分为两组,对照组(30例)给予马来酸依那普利叶酸片与盐酸多奈哌齐治疗,综合组(29例)在对照组方案上加用综合性康复治疗。比较两组患者24 h动态血压水平变化情况;比较两组患者同型半胱氨酸(Hcy)、超敏-C反应蛋白(hs-CRP)水平变化情况;比较两组患者简易精神状态检查表(MMSE)评分、韦氏记忆量表(WMS-RC)评分、长谷川痴呆量表(HDS)评分、日常生活能力(ADL)评分变化情况;统计两组患者血压疗效。结果治疗前,两组患者血压比较,差异均无统计学意义(P>0.05)。治疗后,两组24 h动态血压较治疗前降低,且综合组治疗后低于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者Hcy、hs-CRP比较,差异无统计学意义(P>0.05)。治疗后,两组患者Hcy、hs-CRP均较治疗前降低,且综合组治疗后低于对照组(t=2.477、2.904,P<0.05)。治疗前,两组患者WMS-RC评分比较,差异无统计学意义(P>0.05);治疗后,两组患者图片回忆评分、联想学习评分、背数评分以及综合组治疗后理解记忆评分均较治疗前升高,且综合组治疗后高于对照组,差异均有统计学意义(t=-2.111、-3.112、-2.194、-2.536,P<0.05)。两组治疗前HDS评分、MMSE评分、ADL评分比较,差异无统计学意义(P>0.05);治疗后,两组患者HDS评分、MMSE评分、ADL评分均较治疗前升高,且综合组治疗后高于对照组,差异均有统计学意义(t=-2.114、-2.884、-2.489,P<0.05)。综合组血压总有效率为93.10%(27/29)高于对照组的73.33%(22/30),差异有统计学意义(χ^(2)=4.094,P<0.05)。结论综合性康复联合马来酸依那普利叶酸片与盐酸多奈哌齐治疗H型高血压伴MCI可提高疗效,改善血压和认知功能。
Objective To observe the efficacy of comprehensive rehabilitation combined with enalapril maleate folic acid tablets and donepezil hydrochloride in the treatment of H-type hypertension with mild cognitive impairment(MCI).Methods Fifty-nine patients with H-type hypertension with MCI over 60 years of age admitted to Qixia District Hospital of Nanjing City from January 2023 to June 2024 were selected and randomly divided into two groups using a computer-generated randomization sequence in Microsoft Excel table.The control group was given enalapril maleate folic acid tablets with donepezil hydrochloride for treatment,and the comprehensive group added comprehensive rehabilitation therapy to the control group's program.The two groups were compared in terms of 24 h ambulatory blood pressure,homocysteine(Hcy),high-sensitivity-C-reactive protein(hs-CRP),the score of the Mini-Mental State Examination(MMSE),Wei-style Memory Scale(WMS-RC)score,Hasegawa Dementia Scale(HDS)score,and changes in the score of the ability to perform activities of daily living(ADL)to statistically measure the efficacy of the two groups in terms of blood pressure treatment.Results Comparison of the 24-hour dynamic blood pressure situation before treatment between the two groups was conducted;the difference is not statistically significant(P>0.05).The 24h dynamic blood pressure of both groups after treatment was lower than that before treatment,and the comprehensive group was lower than the control group after treatment(P<0.05).Comparison of Hcy and hs-CRP before treatment in the two groups showed no statistically significant difference(P>0.05).Hcy and hs-CRP were lower than before treatment in both groups after treatment,and were lower in the comprehensive group than in the control group after treatment(P<0.05).Comparison of WMS-RC scores before treatment between the two groups showed no statistically significant difference(P>0.05).Picture recall scores,associative learning scores,back-counting scores,and comprehension memory collocations were higher in both groups after treatment compared with before treatment,and were higher in the integrated group than in the control group after treatment(P<0.05).Comparison of HDS scores,MMSE scores,and ADL scores before treatment between the two groups showed no statistically significant difference(P>0.05).HDS scores,MMSE scores,ADL scores of both groups after treatment were higher than before treatment,and the comprehensive group was higher than the control group after treatment(P<0.05).The total effective rate of blood pressure in the composite group was 93.10%higher than 73.33%in the control group in comparison,and the difference was statistically significant(P<0.05).Conclusion Comprehensive rehabilitation combined with enalapril maleate folic acid tablets and donepezil hydrochloride for the treatment of H-type hypertension with MCI improves efficacy,blood pressure and cognitive function.
作者
杨娟
谈春蕾
葛路
YANG Juan;TAN Chunlei;GE Lu(Department of Cardiovascular Medicine,Qixia District Hospital,Nanjing 210046,China)
出处
《中华保健医学杂志》
2025年第6期967-971,共5页
Chinese Journal of Health Care and Medicine
基金
江苏省预防医学科研课题项目(Y2023005)。
关键词
综合性康复
马来酸依那普利叶酸片
盐酸多奈哌齐
H型高血压
轻度认知障碍
comprehensive rehabilitation
enalapril maleate folic acid tablets
donepezil hydrochloride
hypertension type H
mild cognitive impairment
