氨氯地平阿托伐他汀对高血压合并冠心病患者心血管活性肽、炎症因子及血管内皮功能的影响

Influence of amlodipine/atorvastatin on cardiovascular bioactive peptides,inflammatory factors and vascular endothelial function in patients with hypertension complicated by coronary heart disease

目的研究氨氯地平阿托伐他汀钙片治疗高血压合并冠状动脉粥样硬化性心脏病(冠心病)患者的临床疗效、依从性及对心血管活性肽及血管内皮功能的影响。方法选择2018年4月至2019年12月于保定市第三中心医院就诊的高血压合并冠心病患者230例,随机分为对照组和观察组,每组各115例。对照组口服氨氯地平和阿托伐他汀,观察组口服复方苯磺酸氨氯地平阿托伐他汀钙片,连续治疗6个月。记录临床疗效、服药依从性和不良反应发生情况。比较两组患者治疗前后血浆心血管活性肽水平及血管内皮功能的差异。结果治疗后,观察组患者依从率高于对照组(P=0.007)。两组患者降压总有效率、冠心病总有效率、血浆心血管活性肽Apelin、Salusins-α、ghrelin、Salusins-β水平以及血管内皮功能[血浆内皮素1(ET-1)、一氧化氮(NO)、血管扩张功能(FMD%)]比较,差异均无统计学意义(P均>0.05),经非劣效性检验,观察组非劣效于对照组(P<0.05)。两组治疗期间不良反应发生率为[9.73%(11/113)vs.6.25%(7/112)],无统计学差异(P>0.05)。结论高血压合并冠心病患者应用氨氯地平阿托伐他汀钙片治疗可获得良好的疗效,有效改善血管内皮功能,且服药依从性良好。

Objective To study the clinical efficacy,compliance and influence of Amlodipine Atorvastatin Calcium Tablet on cardiovascular bioactive peptides and vascular endothelial function in patients with hypertension complicated by coronary heart disease(CHD).Methods The patients(n=230)were chosen and divided randomly into control group and observation group(each n=115)from Apr.2018 to Dec.2019.The control group was orally given amlodipine/atorvastatin,and observation was orally given Amlodipine Atorvastatin Calcium Tablet for 6 months continuously.The clinical efficacy,medication compliance and incidence of adverse reactions were recorded.The difference in level of plasma cardiovascular bioactive peptides and vascular endothelial function was compared between 2 groups.Results After treatment,medication compliance was good in observation group,which was higher in observation group than that in control group(P=0.007).The difference in the total effective rate of anti-hypertension,total effective rate of CHD,levels of cardiovascular bioactive peptides(including Apelin,Salusins-α,ghrelin and Salusins-β)and vascular endothelial function(including ET-1,NO and FMD%)had no statistical significance between 2 group(all P>0.05),and the results of non-inferiority test showed that observation group was not inferior to control group(P<0.05).The incidence rate of adverse reactions had no statistical difference between 2 groups[9.73%(11/113)vs.6.25%(7/112),P>0.05].Conclusion Amlodipine Atorvastatin Calcium Tablet has a higher curative effect and can effectively improve vascular endothelial function with good medication compliance in patients with hypertension complicated by CHD.