他汀类药物对老年高血压患者颈动脉内膜中层厚度及血清ⅡA型分泌型磷脂酶A2的影响

Effects of statins on carotid intima-media thickness and secretory type Ⅱ A phospholipase A2 in elderly patients with hypertensive

目的 观察他汀类药物对老年高血压患者颈动脉内膜中层厚度（CIMT）及ⅡA型分泌型磷脂酶A2（sPLA2 ⅡA）的影响.方法 选取2010年1月至2013年6月厦门大学附属第一医院住院和门诊≥65岁的老年高血压患者101例,采用随机数字表法将患者分为阿托伐他汀组（52例）和瑞舒伐他汀组（49例）,分别接受阿托伐他汀20 mg/d及瑞舒伐他汀10 mg/d为期12个月的治疗.采用彩色多普勒超声测定CIMT,采用酶联免疫吸附法测定血清sPLA2 ⅡA水平.对比2组患者用药前后血脂、CIMT及sPLA2 ⅡA水平.结果 治疗12个月后,2组患者总胆固醇、低密度脂蛋白胆固醇（LDL-C）及三酰甘油较治疗前降低（均P ＜0.05）,高密度脂蛋白胆固醇变化差异无统计学意义（P＞0.05）.治疗后瑞舒伐他汀组LDL-C水平低于阿托伐他汀组[（1.94±0.51） mmol/L比（2.11 ±0.25）mmol/L,P＜0.05].2组患者最大CIMT较治疗前变薄[阿托伐他汀组：（1.16 ±0.68）mm比（1.27 ±0.75） mm;瑞舒伐他汀组：（1.18 ±0.59）mm比（1.31 ±0.62） mm,P＜0.05],血清sPLA2 ⅡA水平较治疗前降低[阿托伐他汀组：（3.1 ±0.6） μg/L比（4.4±1.0） μg/L;瑞舒伐他汀组：（3.2±0.8）μg/L比（4.4±1.0） μg/L]（均P＜0.05）.结论 他汀类药物可以降低血清sPLA2ⅡA水平,对老年高血压患者颈动脉粥样硬化有保护作用.

Objective To observe the effects of statins on carotidintima-media thickness （CIMT） and secretory type ⅡA phospholipase A2 （sPLA2 ⅡA） in elderly patients with hypertension.Methods Totally 101 elderly patients （≥65 years old） from January 2010 to June 2013 were randomly divided into atorvastatin group （52 cases） receiving atorvastatin 20 mg/d for 12 months,and rosuvastatin group （49 cases） receing rosuvastatin 10 mg/d for 12 months.The CIMT was measured by color doppler ultrasound,the level of sPLA2 ⅡA in plasma were determined by enzyme linked immunosorbent assay.The of CIMT and sPLA2 ⅡA before and after treatment were compared in the two groups.Results The total cholesterol,low-density lipoprotein cholesterol （LDL-C） and triglycerides were significantly reduced compared with those before treatment in atorvastatin group （all P 〈 0.05）,the level of high density lipoprotein cholesterol had no significant change after treatment （P 〉 0.05）.The level of LDL-C was significantly lower in rosuvastatin group than that in atorvastatin group [（1.94 ± 0.51） mmol/L vs （2.11 ±0.25） mmol/L] （P 〈0.05）.The maximal CIMT after treatment significantly reduced compared with that before treatment in both atorvastatin group [（1.16 ±0.68） mm vs （1.27 ±0.75） mm] and rosuvastatingroup [（1.18 ±0.59） mm vs （1.31 ±0.62） mm] （P〈0.05）.The level of sPLA2 ⅡA was significantly decreased after treatment compared with that before treatment in atorvastatin group [（3.1 ±0.6） μg/L vs （4.4± 1.0） μg/L] and rosuvastatin group [（3.2 ±0.8） μg/L vs （4.4 ± 1.0） μg/L] （P 〈0.05）.Conclusion Statins can effectively reduced the level of plasma sPLA2 ⅡA and protective function on carotid atherosclerosis in elderly patients with hypertension.