氨氯地平联合阿托伐他汀对慢性心力衰竭合并高血压、糖尿病患者血管内皮舒缩因子、外周血EPC数量的影响

Effects of amlodipine combined with atorvastatin calcium tablets on vascular endothelium-derived relaxing factors,endothelium-derived contracting factors and the number of EPC from peripheral blood of patients with coronary heart disease and chronic heart failure complicated with hypertension and diabetes mellitus

目的研究氨氯地平联合阿托伐他汀钙片对冠心病慢性心力衰竭合并高血压、糖尿病患者血管内皮舒缩因子、外周血EPC数量的影响。方法选取2017年1月至2018年2月收治的冠心病慢性心力衰竭合并高血压、糖尿病患者120例,患者根据随机数字表法分为观察组和对照组,每组60例。对照组采用氨氯地平治疗,观察组在氨氯地平的基础上联合阿托伐他汀钙片治疗,分析2组患者治疗前后的血管内皮舒缩因子水平、外周血内皮祖细胞(EPC)数量和血脂水平,并对比治疗效果。结果2组治疗前NO和ET-1水平差异无统计学意义(P>0.05);治疗后,观察组NO水平明显高于对照组,ET-1水平明显低于对照组,差异有统计学意义(P<0.05);治疗后观察组的外周血EPC数量明显高于对照组,差异有统计学意义(P<0.05);2组治疗前的各项血脂水平差异无统计学意义(P>0.05),治疗后,观察组TG、TC和LDL-C水平明显低对照组,HDL-C水平明显高于对照组,差异有统计学意义(P<0.05),且观察组治疗后相较于治疗前,TG、TC和LDL-C水平均明显降低,HDL-C水平明显升高,差异有统计学意义(P<0.05);2组的血压控制有效率差异有统计学意义(P<0.05)。结论对于冠心病慢性心力衰竭合并高血压、糖尿病患者,相比于单独使用氨氯地平,联合使用阿托伐他汀钙能够更有效地改善血管舒缩因子失衡,显著提高外周血EPC数量,起到更好的血管保护作用,同时也能有效调节患者的血脂水平和控制患者血压。

Objective To investigate the effects of amlodipine combined with atorvastatin calcium tablets on the number of endothelium-derived relaxing factor(EDRF),endothelium-derived contracting factor(EDCF)and the number of EPC from peripheral blood of patients with coronary heart disease(CHD)and chronic heart failure complicated by hypertension and diabetes mellitus(DM).Methods A total of 120 patients with CHD and chronic heart failure complicated with hypertension and diabetes were enrolled in this study.The patients were randomly divided into observation group(n=60)and control group(n=60)according to the random number table method.The control group was treated with amlodipine,while the observation group was treated with atorvastatin calcium tablets on the basis of amlodipine.The levels of EDRF and EDCF,the number of EPC from peripheral blood and blood lipid levels were analyzed before and after treatment,and therapeutic effects were compared.Results Before treatment there were no significant differences in the levels of NO and ET-1 between the two groups(P>0.05).After treatment,the NO levels in observation group were significantly higher than those in control group,and the ET 1 levels were significantly lower than those in control group(P<0.05).The number of EPC from peripheral blood in observation group was significantly higher than that in control group after treatment(P<0.05).No significant differences were found in blood lipid levels before treatment between the two groups(P>0.05).After treatment,the levels of TG,TC and LDL-C in observation group were significantly lower than those in control group,and the HDL-C levels were significantly higher than those in control group(P<0.05).After treatment the levels of TG,TC and LDL-C in observation group were significantly lower than those before treatment,and the HDL-C levels were significantly increased(P<0.05).Moreover there was significant difference in the effective rate of blood pressure control between the two groups(P<0.05).Conclusion For the patients with CHD and chronic heart failure complicated by hypertension and DM,the combination application of atorvastatin calcium and amlodipine can improve the imbalance of vasomotion factors and significantly increase the number of EPC from peripheral blood,as compared with amlodipine alone.In addition,which canprotect blood vessles,and effectively regulate thepatient’s blood lipid levels and control the patient’sblood pressure.