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目的 观察依那普利叶酸片联合银杏叶提取物治疗H型高血压患者的血管内皮功能及其外周血清氧化物质浓度的变化,并探讨临床疗效.方法 H型高血压患者120例,并随机均分为对照组(给予降压药依那普利叶酸片和用羟苯磺酸钙改善循环治疗)以及观察组(在对照组基础上给予银杏叶提取物).连续治疗3个月.治疗期间每周电话随访一次,2周门诊随访一次,记录血压及不良反应.3个月后测定收缩压(SBP),舒张压(DBP),同型半胱氨酸(Hcy),血管舒缩张因子[一氧化氮(NO)、内皮素-1(ET-1)]浓度及其血流介导的肱动脉内皮依赖性血管舒张功能(FMD),硝酸甘油介导的血管舒张反应(NMD),脉搏传导速度(PWV),与氧化相关物质[血清超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、活性氧类物质(ROS)活性及其丙二醛(MDA)],并评估临床疗效,记录治疗过程中的不良反应.结果 治疗后两组SBP、DBP、Hcy均显著低于治疗前(均P＜0.05),但两组间比较差异无统计学意义(均P＞0.05).治疗后两组患者NO、FMD、NMD、GSH-Px、SOD均显著高于治疗前(均P＜0.05),且观察组均显著高于对照组(均P＜0.05).治疗后两组患者ET-1、PWV、ROS、MDA均显著低于治疗前(均P＜0.05),且观察组均显著低于对照组(均P＜0.05).治疗过程中两组均未发生严重不良反应,仅出现轻度胃肠道反应、皮疹、干咳等,且两组发生率均无统计学差异(均P＞0.05).结论H型高血压患者在降压的治疗基础上加用银杏叶提取物能通过调节氧化与抗氧化失衡来保护血管内皮,提高临床疗效,安全可靠.“,”Objective To investigate the effects of enalapril folic acid tablets combined with Ginkgo biloba extract on function of vascular endothelium and the concentrations of oxidative related substances in patients with H-type hyper?tension. Methods 120 patients with H-type hypertension were randomly divided into 2 equal groups: control group giv?en antihypertensive enalapril folic acid tablets+calcium dobesilate to improve blood circulation, and observation group given Ginkgo biloba extract in addition to the above-mentioned treatment. The treatment lasted for 3 months during which telephone follow-up was conducted every week and outpatient follow-up was conducted every 2 weeks to mea?sure the systolic blood pressure(SBP)and diastolic blood pressure(DBP)and to observe the adverse events (AEs). After treatment, blood pressure was measured and blood samples were collected to test the fasting plasma glucose (FBG),2-hour postprandial blood glucose(2hPBG),homocysteine(Hcy), nitrogen oxide(NO), endothelin-1(ET-1), superioxide dismutase, SOD), glutathione peroxidase( GSH-Px), reactive oxygen species(ROS), and malondi?aldehyde( MDA). Chromoscope ultrasonic diagnostic equipment was used to test the flow mediated dilation(FMD)of brachial artery and nitroglycerin-mediated dilation(NMD). Arteriosclerosis detector was used to test the pulse wave velocity( PWV).Results After treatment, the SBP, DBP, and Hcy levels of both groups were all significantly lower than those in the same group before treatment(all P＜0.05), however, there were no significant differences in the SBP, DBP, and Hcy levels after treatment between these two groups(all P＞0.05)., the levels of NO, FMD, NMD, GSH-Px, and SOD after treatment were all significantly higher than those before treatment in these two groups(all P＜0.05), and the NO, FMD, NMD, GSH-Px, SOD levels after treatment of the observation group were all significantly higher than those of the control group(all P＜0.05). After treatment, the ET-1 , ROS, and MDA, and PWV levels of these 2 group were all significantly lower than those before treatment(all P＜0.05),; and the ET-1, PWV, ROS, and MDA levels were significantly lower in the observation group than those in the control group(all P＜0.05). Only a few cases of AEs, mainly gastrointestinal events, skin-related AEs, and hacking cough(mostly because of valsartan)were found in these 2 groups and there was no significant differences in the incidences of AEs between these 2 groups(all P＞0.05). Conclusion Treatment with Ginkgo biloba extract helps improve the curative effects for of hyperhomocyste?inemia, probably by improving the function of vascular endothelium.