大剂量阿托伐他汀对原发性高血压合并动脉粥样硬化患者血管微循环及颈动脉斑块进展的影响

Effects of high dose atorvastatin on vascular microcirculation and carotid plaque progression in patients with essential hypertension complicated with atherosclerosis

目的:探究原发性高血压合并动脉粥样硬化患者应用大剂量阿托伐他汀对血管微循环及颈动脉斑块进展的影响。方法:选取我院2019年8月至2020年8月期间收治的127例原发性高血压合并动脉粥样硬化患者,随机分为对照组和观察组。对照组63例患者口服常规剂量阿托伐他汀(20 mg Qd),观察组64例患者口服大剂量阿托伐他汀(40 mg Qd)。3 m后采用氧化酶法检测总胆固醇(Total cholesterol,TC)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterin,LDL-C)、高密度脂蛋白胆固醇(High-density lipoprotein cholesterol,HDL-C)、三酰甘油(Three acyl glycerin,TG)水平;采用比浊法检测纤维蛋白原(Fibrinogen,Fh)、血浆比黏度(Plasma specific viscosity,Np)、全血低切黏度(Whole blood has low shear viscosity,Nbl)、全血高切黏度(High shear viscosity of whole blood,Nbh)水平;采用彩色多普勒超声检测颈动脉血管内中膜厚度(Thickness of endomedia,IMT);同时观察不良反应发生情况。结果:观察组患者TC、TG、LDL-C水平均明显低于对照组,HDL-C水平高于对照组(P<0.05);观察组患者Fh、Np、Nbl、Nbh水平均低于对照组(P<0.05);观察组颈动脉IMT分级优于对照组(P<0.05);两组患者不良发生率比较无明显差异(P>0.05)。结论:大剂量阿托伐他汀能够显著下调原发性高血压合并动脉粥样硬化患者血脂水平,改善血管微循环,缩小颈动脉斑块面积,安全性较高,其效果优于常规剂量阿托伐他汀治疗。

Objective:To investigate the effects of high dose atorvastatin on vascular microcirculation and carotid plaque progression in patients with essential hypertension complicated with atherosclerosis.Methods:A total of 127 patients with essential hypertension complicated with atherosclerosis admitted to our hospital from August 2019 to August 2020 were selected and randomly divided into control group and observation group.Sixty-three patients in the control group received conventional dose of atorvastatin(20 mg Qd,orally)treatment and 64 patients in the observation group received high dose of atorvastatin(40 mg Qd,orally)treatment.After 3 m,the oxidase method was used to detect total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),three acyl glycerin(TG)levels;levels of fibrinogen(Fh),plasma specific viscosity(Np),low shear viscosity of whole blood(Nbl),high shear viscosity of whole blood(Nbh)were measured by turbidimetry,and color doppler ultrasound was used to detect carotid artery intima-media thickness(IMT);meanwhile,adverse reactions were observed.Results:The levels of TC,TG and LDL-C in observation group were significantly lower than those in control group,while hdL-C level was higher than that in control group(P<0.05).The levels of Fh,Np,Nbl and Nbh in observation group were lower than those in control group(P<0.05).The carotid IMT grading of observation group was better than that of control group(P<0.05).There was no significant difference in the incidence of adverse events between 2 groups(P>0.05).Conclusions:High dose of atorvastatin can significantly reduce blood lipid level,improve vascular microcirculation and reduce carotid plaque area in patients with essential hypertension complicated with atherosclerosis,with high safety,and its effect is better than conventional dose of atorvastatin treatment.