瑞舒伐他汀与拉西地平联合应用对高血压病患者颈动脉粥样硬化斑块的影响

Effect of combined therapy with rosuvastatin and lacidipine on carotid atherosclerotic plaques in patients with hypertension

目的研究瑞舒伐他汀降脂、拉西地平达标降压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。方法筛选60例高血压病合并高脂血症颈动脉内膜中层厚度增厚和粥样硬化斑块的患者,随机分为治疗组(A组)和对照组(B组),给予阿司匹林(拜阿司匹林)0.1 g,1次/d,在此基础上,A组给予瑞舒伐他汀(托妥)10 mg,每晚1次,拉西地平(乐息平)4 mg,1次/d口服;B组给予普伐他汀(美百乐镇)20 mg,每晚1次,拉西地平4 mg,1次/d口服。血压不达标者拉西地平加至8 mg,1次/d,再加用氢氯噻嗪12.5～25.0 mg,1次/d。12个月后观察CIMT和粥样硬化斑块的变化。结果 A、B两组均可降低CIMT和消退颈动脉斑块,但A组较B组CIMT降低更明显(P<0.01),颈动脉斑块消退更明显(P<0.01),差异有统计学意义(P<0.01)。结论瑞舒伐他汀与拉西地平联合应用,可以发挥降压和抗动脉粥样硬化的协同作用。

Objective To investigate the effect of combined therapy with rosuvastatin and lacidipine on caroid artery intima-media thickness（CIMT） and carotid atherosclerotic plaques in patients with hypertension.Methods Sixty hypertension patients with different extent of carotid atheroma were randomly divided into two groups.Beside aspirin 0.1 g,1 time/d oral,30 patients in treatment group received lacidipine 4 mg,1 time/d oral and rosuvastatin 10 mg,1 time/d oral,and 30 patients in control group received lacidipine 4 mg,1 time/d oral and prastatin 20 mg,1 time per night oral.The dose of lacidipine was increased by 8 mg per day and then hydrochlorthiazide 12.5-25.0 mg 1 time/d oral was added if blood presures was not controlled properly.The changes of CIMTs and the plaques were observed 12 months later.Results Both of two groups can efficiently reduce the CIMTs and the plaques.But the CIMTs and the plaques in treatment gruop were significantly reduced than that in control gruop after treatment.There were significant differences between the two groups（P〈0.01）.Conclusion Rosuvastatin and lacidipine combined therapy can reduce blood pressure and has antiatherosclerotic effect.