阿司匹林联合阿托伐他汀可改善高血压合并糖尿病病人动脉硬化程度并降低心肌梗死的发生率

Effect of aspirin combined with atorvastatin on arterial stiffness and non-fatal myocardial infarction in elderly patients with hypertension and diabetes mellitus

目的研究阿司匹林联合阿托伐他汀对老年高血压合并糖尿病病人动脉硬化程度和非致死性心肌梗死发生情况的影响。方法选择2016年1月至2017年7月在本院治疗的110例老年高血压合并糖尿病病人进行研究,随机分为观察组和对照组,每组各55例。2组病人均进行降糖降压等基础治疗,对照组给予阿托伐他汀治疗,观察组在此基础上联合阿司匹林治疗。对2组病人的血脂水平、动脉硬化程度指标、不良反应发生率、非致死性心肌梗死发生率等进行比较分析。结果治疗后观察组病人的总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平低于对照组,高密度脂蛋白胆固醇(HDL-C)水平高于对照组(P<0.05)。治疗后观察组病人的心踝血管指数(CAVI)低于对照组,踝肱指数(ABI)高于对照组(P<0.05)。随访1年,观察组非致死性心肌梗死发生率为7.27%(4/55),低于对照组的21.82%(12/55),差异有统计学意义(P<0.05)。观察组不良反应发生率为14.55%(8/55),对照组为9.09%(5/55),差异无统计学意义(P>0.05)。结论阿司匹林联合阿托伐他汀对老年高血压合并糖尿病人的动脉硬化程度有良好的改善效果,并能降低心肌梗死的发生率,治疗安全性良好,值得临床推荐。

Objective To investigate the effects of aspirin combined with atorvastatin on arterial stiffness and non-fatal myocardial infarction in the elderly patients with hypertension and diabetes mellitus.mellitus who were treated in our hospital from January 2016 to July 2017 were enrolled in this study.They were divided into observation group and control group according to random number table method,with 55 cases in each group. The two groups were treated with basic treatment such as lowering blood sugar and blood pressure. The control group was treated with atorvastatin,while the observation group was treated with aspirin combined with atorvastatin. The blood lipid level,arterial stiffness index,incidence of adverse reactions and non-fatal myocardial infarction in the two groups were evaluated and compared. Results The levels of total cholesterol( TC),triglyceride( TG)and low density lipoprotein cholesterol( LDL-C) in the observation group were significantly lower than those in the control group,while the level of high density lipoprotein cholesterol( HDL-C) was significantly higher than that in the control group( P < 0. 05). After treatment,the level of cardioankle vascular index( CAVI) in the observation group was lower than that in the control group,while the ankle-brachial index( ABI) was higher than that in the control group( P < 0. 05). The incidence rate of non-fatal myocardial infarction in the observation group was 7. 27 %,which was lower than that in the control group( 21. 82 %,P < 0. 05). The incidence rate of adverse reactions was 14. 55 %in the observation group and 9. 09 % in the control group,with no significant difference between the two groups( P > 0. 05). Conclusions Aspirin combined with atorvastatin can improve arterial stiffness in the elderly patients with hypertension and diabetes mellitus,and can reduce the incidence of myocardial infarction. The treatment is safe and worthy of clinical recommendation.