叶酸片联合阿托伐他汀治疗对H型高血压患者同型半胱氨酸及颈动脉粥样硬化的影响

Effects of atorvastatin and folic acid tablets on homocysteine and carotid atherosclerosis in patients with type H hypertension

目的:分析H型高血压患者应用叶酸片与阿托伐他汀联合治疗对血浆同型半胱氨酸及颈动脉粥样硬化的影响。方法:选取我院2016年1月至2018年10月收治的140例H型高血压患者为研究对象,按随机数字表法分为观察组(70例)和对照组(70例),对照组给予常规降压+阿托伐他汀钙片治疗,观察组给予常规降压+阿托伐他汀钙片+叶酸片治疗,疗程均为10周。比较2组治疗前后同型半胱氨酸(homocysteine,Hcy)、低密度脂蛋白(low-density lipoprotein,LDL)、肱踝脉搏波传导速度(brachial-ankle pulse wave velocity,BaPWV)、颈动脉内膜-中膜厚度(carotid intima-media thickness,IMT)、血压及心率水平变化,并观察不良反应发生情况。结果:观察组治疗后血浆Hcy及LDL水平明显低于对照组(P<0.05);两组治疗后BaPWV和IMT比较差异均有统计学意义(P<0.05);治疗后,两组患者的收缩压和舒张压较治疗前均明显降低(P<0.05),且观察组治疗后的收缩压和舒张压明显低于对照组(P<0.05),但两组治疗后心率比较差异无统计学意义(P>0.05);两组不良反应发生率比较无统计学差异(P>0.05)。结论:对于H型高血压应用阿托伐他汀联合叶酸片治疗可有效减轻患者颈动脉粥样硬化程度,降低Hcy及LDL水平,且临床较为安全。

AIM:To analyze the effects of atorvastatin and folic acid tablets on homocysteine and carotid atherosclerosis in patients with type H hypertension.METHODS:A total of 140 patients with Htype hypertension admitted to our hospital from January 2016 to October 2018 were enrolled in the study.Random number table method was divided into observation group(70 cases)and control group(70 cases).The control group was treated with folic acid tablets on the basis of routine blood pressure reduction.The observation group was given atorvastatin calcium tablets on the basis of the control group,and the treatment was 10 weeks.Comparing the two groups of homocysteine,low-density lipoprotein,brachial-ankle pulse wave velocity,carotid intimamedia thicknessbefore and after treatment,blood pressure and heart rate levels,and observed the occurrence of adverse reactions.During a follow-up of one year,the incidence of cardiovascular and cerebrovascular events was compared between the two groups.RESULTS:The plasma Hcy level and LDL level in the observation group was significantly lower than that in the control group(P<0.05).There was significant difference in BaPWV and IMT between the two groups(P<0.05).After treatment,the systolic and diastolic blood pressures of the two groups were treated.The systolic blood pressure and diastolic blood pressure were significantly lower than those in the control group(P<0.05),but there was no significant difference in heart rate between the two groups after treatment(P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).CONCLUSION:Atorvastatin combined with folic acid tablets can effectively reduce carotid atherosclerosis in patients with type H hypertension,and it can reduce the levels of Hcy and LDL,and it is clinically safe.