氟伐他汀缓释片治疗血脂异常合并高血压患者的疗效及安全性

Efficacy and safety of fluvastatin sustained-release tablets in treatment of dyslipidemia and hypertension

目的探讨氟伐他汀缓释片治疗血脂异常合并高血压患者的疗效及安全性。方法选取安徽省立医院2014年1月至2016年1月心内科门诊血脂异常合并高血压患者120例,每晚分别给予氟伐他汀缓释片80 mg,治疗12周,最终有115例患者纳入统计。测定患者治疗前后血脂、超敏C反应蛋白(hs-CRP)水平,并监测24 h动态血压,将低密度脂蛋白胆固醇(LDL-C)变化幅度与患者动态血压变化值进行比较。结果氟伐他汀治疗后与治疗前相比,胆固醇[(5.40±0.85)mmol/L vs(4.10±0.95)mmol/L]、LDL-C[(3.58±0.61)mmol/L vs(2.49±0.64)mmol/L]均下降,同时,非高密度脂蛋白胆固醇、三酰甘油、高密度脂蛋白胆固醇水平均得到改善,差异均有统计学意义(P<0.05)。治疗后24 h平均血压值、24 h平均脉压差[(104.96±10.98)mm Hg vs(97.4±9.88)mm Hg]、白昼收缩压变异性[(17.39±4.08)mm Hg vs(14.31±5.09)mm Hg)]及夜间收缩压变异性[(15.50±4.08)mm Hg vs(12.89±8.09)mm Hg)]、hs-CRP[(2.65±10.55)mg/L vs(4.45±8.61 mg/L)]水平也呈下降趋势,差异均有统计学意义(P<0.05)。治疗前后,谷丙转氨酶、谷草转氨酶水平差异无统计学意义(P>0.05)。LDL-C下降幅度在一定程度上与24 h平均血压变化值、白昼收缩压变异性、夜间血压变异性均有关。结论氟伐他汀缓释片降脂疗效可靠,安全性好,同时具有一定抗炎作用,并参与血压节律的调节。

Objective To observe the efficacy and safetyof fluvastatin sustained-release tablets in the treatment of dyslipidemia in patients with hypertension. Methods A total of 120 patients of dyslipidemia with mild to moderate hypertension were selected,who were treated with fluvastatin sustained-release tablets 80 mg once every night for a follow-up of 12 weeks,then 115 of them were recruited in statistical analysis. Blood lipid,high sensitive C reactive protein(hs-CRP),as well as 24 h ambulatory blood pressure parameters were measured before and after treatment. The change of low density lipoprotein cholesterol was compared and analysed in correlation with the dynamic blood pressure change. Results Compared with before treatment,the serum triglycerides(TG),total cholesterol(TC) [(5. 40 ± 0. 85) mmol/L vs(4. 10 ± 0. 95) mmol/L],low density lipoprotein cholesterol(LDL-C) [(3. 58 ± 0. 61) mmol/L vs(2. 49 ± 0. 64) mmol/L]decreased after treatment; meanwhile,non-high density lipoprotein cholesterol(non HDL-C),24 h average pulse pressure(24 h MAP) [(104. 96 ±10. 98) mm Hg vs(97. 4 ± 9. 88) mm Hg],daytime systolic blood pressure variability(d SBPV) [(17. 3 ± 4. 08) mm Hg vs(14. 3 ± 5. 09) mmHg],nightime systolic blood pressure variability(d DBPV) [(15. 50 ± 4. 08) mm Hg vs(12. 89 ± 8. 09) mm Hg],hs-CRP level [(2. 65 ±10. 55) mg/L vs(4. 45 ± 8. 61) mg/L]were all lower with statistical significance(P < 0. 05); high density lipoprotein cholesterol(HDL-C)level after treatment was significantly higher(P < 0. 05). However,glutamic pyruvic transaminase(ALT),aspartate aminotransferase(AST)had no significant difference(P > 0. 05). To some degree,the changes of LDL-C amplitude were influenced by the changes of 24 h MAP,d SBPV,d DBPV. Conclusion Fluvastatin has reliable curative effect and good safety in lowering lipid,at the same time it can be anti-inflammatory,involved in blood pressure rhythm adjustment.