通心络联合阿托伐他汀治疗H型高血压颈动脉粥样硬化疗效分析及对血浆L-PGDS及内脂素水平的影响

Efficacy of TXL combined with atorvastatin in the treatment of H-hypertension carotid atherosclerosis and its influence on plasma L-PGDS and visfatin

目的探讨通心络联合阿托伐他汀治疗H型高血压颈动脉粥样硬化的疗效及对血浆脂质运载蛋白型前列腺素D合成酶(L-PGDS)、内脂素水平的影响。方法选取2011年7月至2014年6月我院收治的60例H型高血压颈动脉粥样硬化患者为研究对象,按数字表法将所有患者随机分为对照组和观察组,每组各30例。两组患者均给予口服阿托伐他汀钙片20 mg/次,1次/d;观察组患者加服通心络胶囊3粒/次,3次/d,连续治疗12个月。采用散射比浊法测定CRP,放射免疫法测定TNF-α,ELISA法检测内脂素、L-PGDS水平,比较两组治疗前后血压、血脂、颈动脉内膜中层厚度(IMT)、斑块Crouse积分、CRP、TNF-α、内脂素、L-PGDS水平。结果治疗后,两组血压、TC、TG、LDL水平均显著降低(P<0.05),HDL水平升高(P<0.05),观察组血压、TC、TG、LDL水平低于对照组(P<0.05),HDL水平高于对照组(P<0.05);治疗后,两组IMT、斑块Crouse积分均显著降低(P<0.05),观察组IMT、斑块Crouse积分低于对照组(t=2.673、3.544,P<0.05);治疗后两组内脂素均显著降低(P<0.05),L-PGDS水平升高(P<0.05),治疗后观察组内脂素水平显著低于对照组(t=4.685,P<0.05),L-PGDS水平显著高于对照组(t=2.286,P<0.05);治疗后CRP、Hcy、TNF-α水平均显著降低(P<0.05),治疗后观察组CRP、Hcy及TNF-α水平显著低于对照组(t=2.983、2.633、2.144,P<0.05)。结论通心络联合阿托伐他汀治疗H型高血压颈动脉粥样硬化疗效显著,可能与下调内脂素及上调L-PGDS表达水平有关。

Objective To investigate the efficacy of TXL combined with atorvastatin in the treatment of H-hy- pertension carotid atherosclerosis and its influence on plasma L-PGDS and visfatin level. Methods A total of 60 pa- tients with H-hypertensive carotid atherosclerosis from July 2011 to June 2014 in our hospital were selected and ran- domly divided into control group and observation group according to the random number table, 30 cases in each group. Patients of both groups were given oral atorvastatin calcium 20 mg per time, once daily; observation group was given additional Tongxinluo 3 pills per time,3 times daily, for 12 months consecutive treatment. CRP was measured by scattering turbidity and TNF-α was measured by radioimmunoassay, while visfatin and L-PGDS levels were detected by ELISA method. The blood pressure, cholesterol, carotid intima-media thickness （ IMT ） , plaque Crouse score, CRP, TNF-α, visfatin and L-PGDS levels before and after treatment were compared. Results After treatment, the blood pressure ,TC, TG and LDL decreased（ P 〈 0. 05 ）, while HDL levels increased（ P 〈 0.05 ）. The blood pressure, TC, TG and LDL levels in observation group were significantly lower than those of control group （ P 〈 0. 05 ） with higher HDL levels （P 〈 0.05 ）. After treatment, the IMT and plaque Crouse score decreased（ P 〈 0. 05 ）, and IMT plaque Crouse in observation group were significantly lower than that of control group （ t = 2. 673,3. 544, P 〈 0. 05 ）. After treatment, the visfatin levels decreased（ P 〈 0. 05 ）, while L-PGDS increased（ P 〈 0. 05 ）, visfatin levels in the observation group was significantly lower than that of control group （t =4. 685 ,P 〈0. 05） with higher L-PGDS （t =2. 286,P 〈0. 05）. After treatment,the CRP,Hcy and TNF-α levels decreased（ P 〈 0. 05 ） ,and the levels of them in observation group was sig- nificantly lower than that of control group （ t = 2. 983,2. 633,2. 144, P 〈 0. 05 ）. Conclusion TXL combined with atorvastatin has significant effect on H-hypertension carotid atherosclerosis, and the mechanism may be related to reduc- ing visfatin expression and raising L-PGDS expression level.