氨氯地平对阿托伐他汀调脂作用的影响

The effect of amlodipine on lipid modification of atorvastatin

目的观察氨氯地平对高血压合并冠心病患者阿托伐他汀调脂作用的影响。方法选择高血压合并冠心病患者174例,根据用药情况将患者分为2组,A组86例,以氨氯地平为基础的降压方案+阿托伐他汀;B组88例,无氨氯地平的降压方案+阿托伐他汀。分别观察2组在治疗前,治疗后2、4、8周时血脂、肝功、肌酸激酶等变化及不良反应发生情况。结果 A组与B组患者治疗前血清TC、TG、LDL-C、HDL-C水平差异无统计学意义(P>0.05)。与治疗前比较,A组和B组患者治疗后2、4、8周血清TC、LDL-C水平明显降低,差异有统计学意义(P<0.05);A组患者治疗后4、8周血清HDL-C水平明显升高,8周血清TG水平明显降低,差异有统计学意义(P<0.05);B组患者治疗后2、4、8周血清HDL-C水平虽有升高趋势,TG水平虽有下降趋势,但差异无统计学意义(P>0.05)。与B组比较,A组患者治疗后4、8周血清TC、LDL-C水平明显下降;治疗后8周血清HDL-C水平明显升高,差异有统计学意义(P<0.05)。结论氨氯地平可能加强高血压合并冠心病患者阿托伐他汀的调脂作用,合用无明显不良反应。

Objective To observe the effect of amlodipine on lipid modification of atorvastatin in hypertensive patients complicated with coronary heart disease（CHD）.Methods 174 hypertensive patients complicated with CHD were enrolled in this study and assigned to two groups：Group A was treated with amlodipinebased antihypertensive regimen plus atorvastatin,while group B was treated with nonamlodipine antihypertensive regimen plus atorvastatin.Plasma lipid profile,hepatic enzymes,creatine kinase and adverse events were assessed at baseline and weeks 2,4 and 8 after treatment.Results There was no significant difference between the two groups in the baseline clinical characteristics,such as plasma total cholesterol（TC）,triglyceride（TG）,lowdensity lipoprotein cholesterol（LDL-C）,highdensity lipoprotein cholesterol（HDL-C） levels（P〉0.05）.Compared with the levels before treatment,TC and LDL-C in both groups decreased significantly at weeks 2,4 and 8（P〈0.05）.In group A,HDL-C was elevated at weeks 4 and 8,while TG declined significantly after treatment for 8 weeks（P〈0.05）In group B,HDL-C tended to be higher and TG appeared to be lower at weeks 2,4 and 8 than those before treatment,but the difference did not reach statistical significance（P〉0.05）.In comparison with group B,the levels of TC and LDL-C in group A declined significantly after treatment for 4 and 8 weeks,and HDL-C increased notably after 8week treatment（P〈0.05）.Conclusions Amlodipine may enhance the effect of atorvastatin in regulating lipid profile,and there are no obvious adverse events in the combination treatment with such two classes of drugs in hypertensive patients complicated with CHD.