降压调脂联合应用对老年高血压患者脑血流影响的临床研究

The Clinical Study of Effect of Combined Antihypertensive and Cholesterol Lowering Treatment on Cerebral Blood Flow (CBF) in Elder Patients

[目的]观察降压调脂联合治疗对正常血脂老年高血压患者血压血脂水平及脑血流动力学的影响。[方法]选择2005年9月至2008年9月到枣庄市立医院门诊及住院治疗的128例正常血脂老年高血压患者,给予降压调脂治疗12周,检测血压、血脂,经颅多谱勒超声(TCD)监测大脑中动脉、椎动脉和基底动脉的血流速度与血管搏动指数、阻力指数,并与30名老年健康体检者比较。[结果]治疗12周后,干预组128例中,血压达标的62例,占49.44%,其中血压、血脂水平均达标的占23.44%,血压达标、血脂未达标的占25.00%,血压未达标、血脂达标的占25.00%,血压、血脂均未达标的占26.56%。干预组治疗12周后,收缩压、舒张压、脉压差、总胆固醇略高于对照组(P<0.01)。脑血管TCD异常发生率,治疗前干预组为67.19%,对照组为10.00%(P<0.01);治疗后干预组为35.16%,对照组为6.67%(P<0.01);血压、血脂均达标组为10.00%,与对照组的差异无统计学意义(P>0.05)。[结论]降压调脂联合治疗正常血脂老年高血压患者,对于改善脑血流动力学,降低血压水平有一定效果。

[Objective]To observe the influence of Combined Antihypertensive and cholesterol lowering treatment on the level of hypertension and cholesterol of elderly hypertensive patients with normal cholesterol and CBF Dynamics. [Methods] 128 elderly hypertensive patients with normal cholesterol, who come to Zaozhuang Municipal Hospital for treatment during the period from September 2005,to September 2008 were selected antihypertensive and cholesterol lowering treatment were given for 12 weeks, hypertension and cholesterol was tested the speed of blood flow in the period of contraction and in the period of diastole and the average blood speed, pulse index of blood vessel, resistance index the characteristic of the Variation of TCD spectrum of the middle cerebral artery, vertebral artery and basilar artery were monitored. At the same time, 30 healthy elderly people were selected as control group. [Results]After 12 weeks,among 128 cases of the treatment group,62 cases meet the standard in hypertension,making up 49.44% ;those who meet the standards both in hypertension and in cholesterol account for 23.44% ;those who meet the standard in cholesterol but not in hypertension amount to 25.00% ;those who meet the standard in hypertension but not in cholesterol make up 25.00%; those who meet neither standard make up 25.56%. After 12 weeks treatment, compared with the treatment group, we find the PI and RI of MCA,VA and BA of the treatment group are slightly higher（ P 〈0.01）. Before the treatment,the incidence of abnormal of the double attainment group of cerebrovascular TCD is 67.19% ,the control group is 10. 00% （ P 〈0. 01） ; After the treatment,the treatment group is 35.16%,the control group is 6.67% （ P〈0.01）. Blood,pressure,lipid,compliance group are 10.00%, there is no statistically significant for the control group（ P 〉 0.05）.[Conclusion] Combined Antihypertensive and cholesterol lowering treatment on elderly hypertensive patients with normal cholesterol has a certain effect on CBF Dynamics and lowering hypertension.