氨氯地平联合辛伐他汀对中老年高血压合并颈动脉斑块血压昼夜节律变化的影响及其机制研究

Effect and Mechanism of Amlodipine Combined with Simvastatin on the Circadian Rhythm of Blood Pressure in Middle Aged and Elderly Patients with Hypertension and Carotid Artery Plaque

目的:研究氨氯地平联合辛伐他汀对中老年高血压合并颈动脉斑块血压昼夜节律变化的影响及其机制。方法:选取我院2013年7月-2015年6月中老年高血压合并颈动脉斑块病患者120例,将其随机分为实验组与对照组,各60例。在其他治疗措施相同的基础上,对照组仅采用氨氯地平治疗,实验组采用氨氯地平联合辛伐他汀片治疗方案。观察两组间的疗效及相关指标差异。结果:对照组治疗前、后血HDL-C、LDL-C、TC、TG等指标差异无统计学意义(P>0.05);治疗后,实验组上述指标较对照组明显改善(P<0.05);治疗后,两组患者颈动脉IMT均较治疗前明显降低,且实验组明显低于对照组(P<0.05)。实验组治疗后睡眠期间血压下降率大于日间血压的10%,较治疗前显著降低且实验组低于对照组(P<0.05)。结论:苯磺酸氨氯地平与辛伐他汀联合治疗中老年高血压合并颈动脉斑块患者可有效调节血脂、延缓颈动脉IMT增厚,恢复血压昼夜节律,从而减少发生心血管事件的风险。

Objective：To study the effect of simvastatin combined with amlodipine on the circadian rhythm of blood pressure in middle and elderly aged patients with hypertension and carotid artery plaque.Methods：From July 2013 to June 2015,120 cases of middle and old aged patients with hypertension and carotid plaque in our hospital were divided into experimental group and control group,and 60 patients in each group.The control group was treated with amlodipine,and the experimental group was treated with amlodipine combined with Simvastatin Tablets.The other treatments were the same in the two groups,and the difference of results were observed.Results：In the control group,there was not statistically significant（P〉0.05）in HDL-C,LDL-C,TC,TG before and after treatment;compared with the control group,the index of the experimental group improved more obvious（P〈0.05）after the treatment;the carotid artery IMT in two groups of patients after treatment was significantly reduced than before treatment and the experimental group lower than in the control group（P〈0.05）.In the experimental group,the rate of decrease of blood pressure during sleep was more than 10% of the ambulatory blood pressure,significantly lower than before treatment and the control group（P〈0.05）.Conclusion：The combination therapy with benzene sulfonic acid amlodipine and simvastatin in elder hypertension patients with carotid artery plaques can effectively regulate serum lipid,preventing the thickening of the carotid artery IMT and circadian rhythm of blood pressure recovery,so as to reduce the risk of cardiovascular events.