高血压伴脂代谢紊乱患者心脑血管风险及阿托伐他汀的干预研究

Study on the risk of cardiovascular and cerebrovascular disease and intervention of atorvastatin in hypertension patients complicated with disorders of lipid metabolism

目的探讨高血压伴脂代谢紊乱患者心脑血管风险及应用阿托伐他汀干预治疗的效果。方法选取2013-12-2014-12的54例高血压伴脂代谢紊乱患者为研究对象,设为高血压伴脂代谢紊乱组,另选取54例单纯高血压患者为高血压组。为研究阿托伐他汀的干预效果,再将54例高血压伴脂代谢紊乱患者抽签随机分为观察组和对照组,每组27例。观察组给予阿托伐他汀治疗,对照组给予安慰剂治疗,疗程8周。比较高血压伴脂代谢紊乱组与高血压组心脑血管风险,记录观察组与对照组干预前后的收缩压、舒张压、心率,总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）等血脂水平及不良反应发生率并比较。结果高血压伴脂代谢紊乱组心室肥厚发生率38.89%、冠心病发生率33.33%,高于高血压组的20.37%、16.67%,差异有统计学意义（P〈0.05）。治疗后观察组收缩压、舒张压均低于对照组,差异有统计学意义（P〈0.05）;两组治疗后心率比较差异无统计学意义（P〉0.05）。观察组治疗后TC、TG、LDL-C水平低于对照组,HDL-C水平高于对照组,差异有统计学意义（P〈0.05）。两组不良反应发生率比较差异无统计学意义（P〉0.05）。结论高血压伴脂代谢紊乱患者心脑血管风险较高,应用阿托伐他汀治疗高血压伴脂代谢紊乱,可有效降低患者血压,调节血脂水平,不良反应可耐受,具有较好的临床应用价值。

Objective To study the risk of cardiovascular and cerebrovascular disease and intervention of atorvastatin in hypertension patients complicated with disorders of lipid metabolism. Methods Fifty-four hypertension patients complicated with disorders of lipid metabolism in our hospital from December 2013 to December 2014 were collected as hypertension complicated with disorders of lipid metabolism group,other 54 patients with simple hypertension were taken as hypertension group. To study the intervention effect of atorvastatin,54 hypertension patients complicated with disorders of lipid metabolism were randomly divided into the observation group and the control group,with 27 cases in each group. The observation group was treated with atorvastatin while the control group was treated with placebo for 8 weeks. The risk of cardiovascular and cerebrovascular disease was compared between the hypertension complicated with disorders of lipid metabolism group and the hypertension group. The systolic pressure,diastolic pressure,heart rate,total cholesterol（ TC）,triglyceride（ TG）,low density lipoprotein cholesterol（ LDL-C）,high density lipoprotein cholesterol（ HDL-C）,other blood lipid levels and adverse reactions were recorded before and after the intervention in the observation group and the control group. Results The incidences of ventricular hypertrophy and coronary disease in the hypertension complicated with disorders of lipid metabolism group were significantly higher than those in the hypertension group（ 38. 89% vs 20. 37%,33. 33% vs 16. 67%）（ P〈0. 05）. The systolic pressure and diastolic pressure in the observation group were significantly lower than those in the control group afterthe treatment（ P〈0. 05）. There was no significant difference in heart rate between the two groups after the treatment（ P〈0. 05）. TC,TG and LDL-C levels were significantly lower,and HDL-C level was significantly higher in the observation group than those in the control group after the treatment（ P〈0. 05）. There was no significant difference in adverse reaction rates between the two groups（ P〈0. 05）. Conclusion Hypertension patients complicated with disorders of lipid metabolism have higher risk of cardiovascular and cerebrovascular disease. Atorvastatin can reduce the patients＇ blood pressure effectively,regulate the blood lipid level with tolerable adverse effects in the treatment of hypertension complicated with disorders of lipid metabolism.