阿托伐他汀联合氨氯地平改善高血压病3级老年患者心室重塑效应评估

Assessment on the effect of atorvastatin combined amlodipine on ventricular remodeling in stage 3 elderly patients with hypertension

目的评估高血压病(p HT)3级老年患者应用阿托伐他汀联合氨氯地平治疗对心室重塑的影响。方法本院165例p HT 3级老年患者分为联合组(85例、阿托伐他汀联合氨氯地平);单用组(80例、仅用氨氯地平)。比较2组血压、血脂、血清ADP、MMP-9及LVEDd、LVPWT、IVST、WMSI、IMT指标及总有效率差异。多元Logistic回归分析上述指标与疗效相关性。治疗结束后随访2年,比较2组并发症发生率差异。结果2组治疗前各指标差异均无统计学意义(P>0.05)。治疗后,与单用组相比,联合组血清MMP-9、TC及LDL-C以及LVEDd、LVPWT、IVST、WMSI、IMT降低,而血清ADP与HDL-C水平升高(P<0.05)。联合组总有效率(57.6%)高于单用组(30.0%)(P<0.01)。血清ADP为p HT 3级老年患者疗效的保护性因素,MMP-9为危险性因素。随访2年,联合组各种并发症发生率较单用组更低(P<0.05)。结论氨氯地平联合阿托伐他汀能改善p HT 3级老年患者心室重塑程度。

Objective To assess the effect of amlodipine combined atorvastatin on ventricular remodeling in elderly patients with primary hypertension(p HT)stage 3.Methods The 165 elderly patients with p HT stage 3 in our hospital were chosen and divided into two groups,which were combined group(85 cases,received amlodipine combined atorvastatin)and single group(80 cases,received amlodipine only).Blood pressure,blood lipid,serum ADP,MMP-9,LVEDd,LVPWT,IVST,WMSI,IMT and total effective rate were compared between the two groups.Multivariate Logistic regression analysis showed the correlation between the above indicators and efficacy.The patients were followed up for 2 years after the end of treatment,and the difference of complication rate between the two groups was compared.Results There was no statistical significance on the difference between the two groups in each indicator before treatment(P>0.05).After treatment,compared with the single-use group,serum MMP-9,TC,LDL-C,LVEDd,LVPWT,IVST,WMSI and IMT in the combined group were decreased,while serum ADP and HDL-C levels were increased(P<0.05).The total effective rate of the combined group(57.6%)was higher than that of the single group(30.0%)(P<0.01).Serum ADP is a protective factor for the efficacy of elderly patients with p HT3,and MMP-9 is a risk factor.After 2 years of follow-up,the incidence of complications in the combined group was lower than that in the single group(P<0.05).Conclusion The administration of amlodipine combined atorvastatin can obviously improve the degree of the ventricular remodeling in elderly patients with p HT stage 3.