阿托伐他汀钙对高血压冠心病患者IMT厚度及血脂和心功能的影响

Effects of atorvastatin calcium on IMT thickness,blood fat and cardiac function of patients with hypertension complicated by coronary heart disease

目的探究阿托伐他汀钙对高血压冠心病患者颈动脉内膜、中膜厚传(IMT)厚度及血脂和心功能的影响分析,为高血压合并冠心病的治疗提供理论依据。方法 100例高血压合并冠心病患者,通过回顾性分析的探究方式进行疗效比较。将使用缬沙坦联合氨氯地平治疗的50例患者设为对照组,将阿托伐他汀钙联合氨氯地平治疗的50例患者设为观察组。连续治疗2个月后比较2组患者治疗前后收缩压(SBP)、舒张压(DBP)以及高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、三酰甘油(TG)、总胆固醇(TC)等血脂指标水平变化,并检测两组患者治疗前后颈动脉内膜-中膜(IMT)厚度,通过超声心动图检查治疗前后心脏左室舒张末内径(LVDD)以及左心室射血分数(LVEF)。结果 2组治疗后SBP、DBP均较治疗前显著降低,且观察组显著低于对照组,差异有统计学意义(P<0.01);2组治疗前后HDL-C差异无统计学意义(P>0.05),2组治疗后LDL-C、TG、TC均显著降低,且观察组显著低于对照组,差异有统计学意义(P<0.01);2组治疗后IMT厚度、LVDD显著降低,LVEF显著升高,且2组治疗后比较,差异有统计学意义(P<0.01)。结论在常规降压治疗基础上采用阿托伐他汀钙能显著降低高血压合并冠心病患者血压,改善血脂水平,提高心脏功能,降低IMT厚度以延缓动脉粥样硬化。

Objective To analyze the effects of atorvastatin calcium on IMT thickness,blood lipid and cardiac function of patients with hypertension and coronary heart disease so as to provide theory gist for treatment of hypertension complicated by coronary artery disease. Methods A total of 100 patients with hypertension complicated by coronary heart disease were divided into observation group（ n = 50） and control group（ n = 50）. The patients in observation group were treated by atorvastatin calcium combined with amlodipine,however,the patients in control group were treated by valsartan combined with amlodipine. After 2-month treatment,the changes of systolic blood pressure（ SBP）,diastolic blood pressure（ DBP）,high density lipoprotein（ HDLC）,low density lipoprotein（ LDLC）,triglyceride（ TG） and total cholesterol（ TC）were observed and compared between two groups. Moreover,the carotid intima-media thickness（ IMT）,left ventricular enddiastolic diameter（ LVDD） and left ventricular ejection fraction（ LVEF） before and after treatment were detected and compared between two groups. Results The SBP and DBP were decreased significantly in both groups after treatment,moreover,which in observation group were significantly lower than those in control group（ P〈0. 01）. There were no significant differences in the levels of HDL-C before and after treatment between two groups（ P〈0. 05）,however,the levels of LDL-C,TG and TC were significantly decreased after treatment,moreover,which in observation group were significantly lower than those in control group（ P〈0. 01）. After treatment,the IMT thickness and LVDD were significantly decreased in both groups,however,the LVEF levels were significantly increased,there were significant differences between two groups（ P〈0. 01）. Conclusion On the basis of conventional antihypertension therapy,the atorvastatin calcium can significantly decrease blood pressure, improve blood lipid levels, improve cardiac function and reduce IMT thickness to delay atherosclerosis in patients with hypertension complicated by coronary heart disease.