阿托伐他汀联合厄贝沙坦对原发性高血压患者动脉及心室重塑的改善作用分析

Improvement effect of artery and ventricular remodeling of atorvastatin combined with irbesartan in the treatment of primary hypertension

目的探究阿托伐他汀联合厄贝沙坦对原发性高血压患者动脉及心室重塑的改善作用。方法选择2013年3月—2014年3月收治的原发性高血压患者156例作为研究对象,随机分为对照组和观察组各78例。对照组给予厄贝沙坦片治疗,1片/次,1次/d;观察组在对照组基础上联合阿托伐他汀治疗,2片/次,1次/d。观察并比较两组治疗前后心血管重塑改善情况及血脂变化情况。计量资料组间比较采用t检验,组内比较采用配对t检验,P<0.05为差异有统计学意义。结果治疗后,对照组与观察组SBP、DBP水平分别为(127.75±12.71)、(84.28±7.31)、(124.34±11.48)、(82.13±7.25)mm Hg(1 mm Hg=0.133 k Pa),均较治疗前的(162.24±11.45)、(104.54±8.26)、(161.52±10.71)、(103.47±7.58)mm Hg明显降低,差异均有统计学意义(均P<0.05)。治疗后,观察组与对照组室间膈厚度(interventricular septum thickness,IVST)、左室舒张末期内径(left ventricular end-diastolic dimension,LVEDD)、左室后壁厚度(left ventricular posterior wall,LVPW)、左室质量指数(left ventricular mass index,LVMI)、颈动脉内中膜厚度(intima media thickness,IMT)分别为(10.05±1.14)、(45.17±1.73)、(10.07±1.38)mm、(101.34±14.85)、(0.82±0.12)mm、(11.15±1.27)、(46.79±1.43)、(11.39±1.34)mm、(117.81±14.52)、(0.93±0.12)mm,明显低于治疗前的(13.81±1.42)、(48.24±5.81)、(12.48±1.42)mm、(128.27±24.61)、(0.97±0.13)、(13.74±1.38)、(47.83±5.67)、(12.37±1.45)mm、(126.58±25.63)、(0.98±0.11)mm,差异均有统计学意义(均P<0.05)。两组治疗后各指标比较差异均有统计学意义(均P<0.05)。结论阿托伐他汀联合厄贝沙坦治疗原发性高血压,可有效改善颈动脉及左心室重塑情况,对降低心血管事件及死亡事件发生概率有重要的临床价值。

Objective To investigate the improvement effect of artery and ventricular remodeling of atorvastatin combined with irbesartan in the treatment of primary hypertension.Methods 156 cases of primary hypertension from March 2013 to March2014 were selected and randomly divided into control group and observation group（n=78）.The patients in control gorup were treated with irbesartan,1 tip/time,1 time/d,while the patients in observation group were treated with atorvastatin on the basis of control group,2 tips/time,1 time/d.The improvement effect of ventricular remodeling and changes of blood lipid before and after treatment were recorded and compared.Measurement data between groups was processed by t test,in groups was processed by paired t test,P〈0.05 was considered statistically significant.Results After treatment,the SBP and DBP of control group and observation group were（127.75±12.71）,（84.28±7.31）,（124.34±11.48）,（82.13±7.25）mm Hg（1 mm Hg=0.133 k Pa）,lower than that before treatment[（162.24±11.45）,（104.54±8.26）,（161.52±10.71）,（103.47±7.58）mm Hg],the differences were statistically significant（all P〈0.05）.After treatment,the interventricular septal thickness（IVST）,left ventricular end- diastolic dimension（LVEDD）,left ventricular posterior wall（LVPW）,left ventricular mass index（LVMI）,intima media thickness（IMT） were（10.05±1.14）,（45.17±1.73）,（10.07±1.38）mm,（101.34±14.85）,（0.82±0.12）mm,（11.15±1.27）,（46.79±1.43）,（11.39±1.34）mm,（117.81±14.52）,（0.93±0.12）mm,lower than that before treatmen t [（13.81 ±1.42）,（48.24 ±5.81）,（12.48 ±1.42）mm,（128.27 ±24.61）,（0.97 ±0.13）,（13.74 ±1.38）,（47.83 ±5.67）,（12.37±1.45）mm,（126.58±25.63）,（0.98±0.11）mm],the differences were statistically significant（all P〈0.05）.After treatment,the differences of the indexes between the two groups were statistically significant（all P〈0.05）.Conclusion Atorvastatin combined with irbesartan has good improvement effect of artery and ventricular remodeling in the treatment of primary hypertension,reduce the occurrence of cardiovascular events and death,worthy of clinical application.