阿托伐他汀联合氨氯地平早期大剂量用于高血压并急性冠脉综合征的临床评价

Early Application of Large Dose of Atorvastatin Combined with Amlodipine on Hypertension and Acute Coronary Syndrome

目的探讨发病12 h内应用大剂量阿托伐他汀钙片联合苯磺酸左旋氨氯地平对高血压合并急性冠脉综合征患者的有效性及安全性。方法选取2013年1月至2015年1月因高血压合并急性冠脉综合征住院治疗的患者90例,均分为两组,均行常规治疗,试验组45例12 h内加服阿托伐他汀钙片80 mg、苯磺酸左旋氨氯地平10 mg,顿服;后常规用药阿托伐他汀钙片40 mg,每晚1次,苯磺酸左旋氨氯地平5 mg,每晚1次。对照组45例12 h内加服阿托伐他汀钙片10 mg,每晚1次,苯磺酸左旋氨氯地平10 mg,顿服;后常规用药阿托伐他汀钙片10 mg,每晚1次,苯磺酸左旋氨氯地平5 mg,每晚1次。治疗12个月,第4,12个月时随访,观察两组患者血脂、血压、心血管事件、不良反应发生情况。结果两组治疗后血压及血脂水平均明显下降(P<0.05),但试验组的血压及血脂水平下降更明显(P<0.05),且组间不良反应发生率比较无统计学差异(P>0.05),未发生严重的心血管事件。结论发病12 h内应用大剂量阿托伐他汀钙片联合苯磺酸左旋氨氯地平能改善高血压合并急性冠脉综合征患者的临床预后,使患者在心血管方面获益更多,且无严重的不良事件发生。

Objective To investigate the efficacy and safety of high dose atorvastatin combined with levamlodipine besylate on hyperten- sion and acute coronary syndrome within 12 h. Methods 90 hospitalized patients with hypertension and acute coronary syndrome from January 2013 to January 2015were selected. The regular treatment of all patients was according to the guidelines. The end time was 12 months and the patients were followed up at 4th month and 12th month. The experimental group of 45 cases was given atorvastatin 80 mg and levamlodipine besylate 10 mg at a draught within 12 hours, then took atorvastatin 40 mg and levamlodipine besylate 5 mg once every night as usual. The control group of 45 eases was given atorvastatin 10 mg and levamlodipine besylate 10 mg at a draught within 12 hours, then took atorvastatin 10 mg and levamlodipine besylate 5 mg once every night as usual. The blood lipid, blood pressure, cardiovascu- lar events and adverse reactions were followed up in the two groups. Results The study showed that after treatment the blood pressure and blood lipid were significantly decreased in the two group（ P 〈 0. 05）, but the experimental group decreased more obviously（ P 〈 0.05）. There were no significantly differences in adverse reactions between two groups（P 〉 0. 05）; no serious cardiovascular events occurred in the two groups. Conclusion The application of high dose atorvastatin plus levamlodipine besylate within 12 hours can improve clinical prognosis of patients with hypertension and acute coronary syndrome, obtain more benefit without serious adverse events.