阿托伐他汀钙联合硝苯地平缓释片治疗老年轻中度高血压合并左心室肥厚的临床疗效及其对肝肾功能的影响

Clinical Effect of Atorvastatin Calcium Combined with Nifedipine Sustained-release Tablets on Aged Mild to Moderate Hypertension Complicated with Left Ventricular Hypertrophy and Its Impact on Liver and Kidney Function

目的探究阿托伐他汀钙联合硝苯地平缓释片治疗老年轻中度高血压合并左心室肥厚的临床疗效及其对肝肾功能的影响。方法选择深圳市罗湖区人民医院2011年2月—2013年6月收治的老年轻中度高血压合并左心室肥厚患者150例,按照随机数字表法分为治疗组与对照组,每组75例。对照组患者给予硝苯地平缓释片口服治疗,治疗组患者在对照组基础上联合阿托伐他汀钙治疗,两组患者均治疗18个月。比较两组患者治疗前后血压〔收缩压(SBP)、舒张压(DBP)、脉压(PP)〕、左心室后壁厚度(LVPW)和室间隔厚度(IVS),观察两组患者不良反应发生情况。结果治疗组有6例患者失访,10例患者因血压控制不理想而换用其他降压药物;对照组有5例患者失访,12例患者因血压控制不理想而换用其他降压药物。治疗前两组患者SBP、DBP、PP比较,差异无统计学意义(P>0.05);治疗后治疗组患者SBP、PP低于对照组,DBP高于对照组(P<0.05)。治疗前两组患者LVPW、IVS比较,差异无统计学意义(P>0.05);治疗后治疗组患者LVPM、IVS小于对照组(P<0.05)。治疗组有2例患者出现丙氨酸氨基转移酶(ALT)异常升高,停用阿托伐他汀钙后2周恢复正常;对照组患者未出现明显肝肾功能异常。结论阿托伐他汀钙联合硝苯地平缓释片治疗老年轻中度高血压合并左心室肥厚的临床疗效优于单独应用硝苯地平缓释片,能更有效地改善患者临床症状,且对肝肾功能的影响较小。

Objective To investigate the clinical effect of atorvastatin calcium combined with nifedipine sustained-release tablets on aged mild to moderate hypertension complicated with left ventricular hypertrophy and its impact on liver and kidney function.Methods A total of 150 aged mild to moderate hypertension patients complicated with left ventricular hypertrophy were selected in the People＇s Hospital of Luohu District from February 2011 to June 2013,and they were divided into control group and treatment group according to random number table,each of 75 cases.Patients of control group received nifedipine sustained-release tablets,while patients of treatment group received atorvastatin calcium combined with nifedipine sustained-release tablets,both groups treated for 18 months.Blood pressure（SBP,SDP and PP）,LVPW and IVS before and after treatment were compared between the two groups,and the incidence of adverse reactions was observed.Results Of treatment group,6 cases lost to fellow-up,10 cases changed hypotensive drugs because of ideal control of blood pressure; of control group,5 cases lost to fellow-up,12 cases changed hypotensive drugs because of ideal control of blood pressure.No statistically significant differences of SBP,SDP or PP was found between the two groups before treatment（P〉0.05）; after treatment,SBP and PP of treatment group were statistically significantly lower than those of control group,while DBP of treatment group was statistically significantly higher than that of control group（P〈0.05）.No statistically significant differences of LVPW or IVS was found between the two groups before treatment（P〉0.05）; while LVPM and IVS of treatment group were statistically significant smaller than those of control group（P〈0.05）.Of treatment group,2 cases occurred ALT singularly elevated,and they all recovered after drug withdrawal of atorvastatin calcium,no one of control group occurred any obvious liver or kidney dysfunction.Conclusion Atorvastatin calcium combined with nifedipine sustained-release tablets has better clinical effect than single use of nifedipine sustained-release tablets in treating aged mild to moderate hypertension complicated with left ventricular hypertrophy,can more effectively relieve the clinical symptoms,and has mild impact on liver and kidney function.