瑞舒伐他汀强化降脂对高血压病患者颈动脉粥样硬化斑块的影响

The effect of intensive lipid lowering by rosuvastatin on carotid atherosclerotic plaques in patients with hypertension

目的观察瑞舒伐他汀强化降脂对高血压病患者颈动脉粥样硬化颈动脉内膜-中层厚度(CIMT)及颈动脉斑块的影响。方法 60例高血压合并颈动脉粥样硬化患者随机分为A、B组各30例。试验前测血压、血糖、血脂、肾功能等生化指标,检测CIMT和粥样硬化斑块。A组给予瑞舒伐他汀10mg,每晚1次,贝尼地平4mg,每天1次;B组给予瑞舒伐他汀20mg,每晚1次,贝尼地平4mg,每天1次,控制血压及强化降脂。血压不达标者,加用氢氯噻嗪12.5～25mg,每天1次。治疗6个月后检测CIMT和颈动脉斑块的变化。结果 2组均可降低CIMT和消退颈动脉斑块,差异均有统计学意义(P<0.01)。但B组较A组CIMT降低和颈动脉斑块消退更明显,差异均有统计学意义(P<0.01)。结论高血压病合并颈动脉粥样硬化患者,瑞舒伐他汀强化降脂治疗后可显著降低CIMT,并可以明显消退颈动脉斑块。

Objective To observe the effect of intensive lipid lowering by rosuvastatin on caroid artery intima-media thickness（CIMT）and carotid atherosclerotic plaques in patients with hypertension.Methods 60 cases of hypertension patients with different extent of carotid atheroma were randomly divided into group A and group B,30 cases of each.Blood pressure,blood glucose,serum lipids,renal function,CIMT and carotid atherosclerotic plaques were measured before treatment of the two groups.Group A received benidipine 4mg po qd and rosuvastatin 10mg po qn,Group B received benidipine 4mg po qd and rosuvastatin 20mg po qn.Hydrochlorthiazide 12.5~25mg po qd was added if blood presures not controlled properly.All the patients received the cervical artery ultrasonic,Observed the changes of CIMT and the plaques six months later.Results Both of two groups can efficiently reduced the CIMTs and the plaques The differences were statistically significant（P0.01）.In contrast,the CIMTs and the plaques in group B were significantly reduced than that of group A after treatment.The differences were statistically singificant（P0.01）.Conclusion Intensive treatment by rosuvastatin can remarkably decrease CIMTs and reduce carotid atherosclerotic plaques significantly.