漳州地区高血压患者血脂分布及不同剂量的阿托伐他汀的降脂达标情况分析

Lipid profiles of patients with essential hypertension in Zhangzhou Region and different dosages of atorvastatin in decreasing low-density lipoprotein concentrations

目的分析漳州地区原发性高血压(essential hypertension,EH)患者的血脂分布及他汀类药物应用情况,探讨不同剂量的阿托伐他汀对EH人群的动脉粥样硬化性心血管疾病(ASCVD)一级预防降脂达标效果。方法选择到漳州市医院就诊的EH患者333例,检测血脂[三酰甘油(triacylglycerol,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)]浓度,分析血脂分布及他汀类药物应用情况。按随机数字表法随机分为小剂量阿托伐他汀组(n=170,立普妥10 mg,睡前顿服一次)及常规剂量阿托伐他汀组(n=163,立普妥20 mg,睡前顿服一次),疗程均为3个月。检测两组治疗后血脂浓度,同时对两组血糖、肝功能、肾功能、肌酸激酶进行检测并比较。结果漳州地区高血压患者治疗前TG为(1.67±0.95)mmol/L,TC为(5.58±0.67)mmol/L,LDL-C为(3.42±0.51)mmol/L,HDL-C为(1.23±0.32)mmol/L。治疗3个月后,应用小剂量阿托伐他汀及常规剂量阿托伐他汀组血清TG、TC、LDL-C浓度均显著降低,差异有统计学意义(P均<0.01)。常规剂量阿托伐他汀组在降低血清LDL-C浓度的幅度上明显高于小剂量组,差异有统计学意义(P<0.01);小剂量阿托伐他汀组达标率为78%,常规剂量阿托伐他汀组达标率为82%,两组达标率比较差异无统计学意义(P>0.05)。结论漳州地区EH患者的血脂处于较低水平;小剂量阿托伐他汀能够显著降低血清LDL-C浓度,且副作用少,值得在动脉粥样硬化性心血管疾病一级预防中长期推广应用。

Objectives To investigate the lipid profiles of patients with essential hypertension （EH） in Zhangzhou Region and the roles of different dosages of atorvastatin in decreasing low-density lipoprotein （LDL） concentrations for primary prevention of arteriosclerotic cardiovascular disease （ASCVD）. Methods A total of 333 patients with EH were enrolled in the study. Serum concentrations of triacylglycerol （TG）, total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C） and high-density lipoprotein cholesterol （HDL-C） were measured. Then the patients were randomly divided into low-dose treatment group （n=170） and standard-dose treatment group （n=163）. Low-dose treatment group was given atorvastatin 10 mg once at night and standard-dose treatment group received atorvastatin 20 mg once at night. The two groups were treated for 3 months. After treatment, lipid concentrations, liver function and creatine kinase （CK） concentrations of the two groups were measured and compared. Results Before treatment, serum concentrations of TG, TC, LDL-C and HDL-C were （ 1.67±0.95） mmol/L, （5.58±0.67） mmol/L, （3.42±0.51 ） mmol/L and （1.23 ±0.32） mmol/L, respectively. After treatment with atorvastatin for 3 months, TG, TC and LDL-C concentrations significantly reduced （all P〈0.01 ）. LDL-C lowering range in standard-dose treatment group was significantly larger than that in low-dose treatment group （P〈0.01）. Control rates of low-dose treatment group and standard-dose treatment group were 78% and 82%, respectively, but there was no remarkable difference between them （P〉0.05）. Conclusions The lipid concentrations of patients with EH in Zhangzhou Region are relatively in a low profile. Low dosage of atorvastatin treatment can significantly decrease LDL-C concentrations with few side-effects, which is worth applying in primary prevention of ASCVD.