依折麦布联合阿托伐他汀治疗原发性高血压病合并2型糖尿病的临床疗效

Effect of ezetimibe combined with atorvastatin for essential hypertension patients complicated with type 2 diabetes mellitus

目的观察依折麦布联合阿托伐他汀治疗原发性高血压病(EH)合并2型糖尿病(T2DM)的临床疗效。方法选取2020年1月—2022年5月福建医科大学附属泉州第一医院收治的EH合并T2DM患者90例,依据编号奇偶数分为对照组与观察组,各45例。对照组给予阿托伐他汀钙片,观察组在对照组基础上加用依折麦布片,2组均治疗3个月。比较2组治疗前与治疗3个月后血脂指标[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、血液黏度指标[全血低切黏度(LBV)、全血高切黏度(HBV)]及其他相关血液生化指标[血细胞比容(HCT)、红细胞沉降率(ESR)、超敏C反应蛋白(hs-CRP)、N末端脑钠肽前体(NT-proBNP)、基质金属蛋白酶-9(MMP-9)、白介素-1β(IL-1β)],不良反应。结果治疗3个月后,2组TC、TG、LDL-C水平低于治疗前,HDL-C水平高于治疗前,且观察组降低/升高幅度大于对照组(P<0.01);2组LBV、HBV低于治疗前,且观察组低于对照组(P<0.01);2组HCT、ESR及血清hs-CRP、NT-proBNP、MMP-9、IL-1β水平低于治疗前,且观察组低于对照组(P<0.05或P<0.01)。观察组不良反应总发生率与对照组比较,差异无统计学意义(11.11%vs.13.33%,χ^(2)=0.104,P=0.748)。结论依折麦布联合阿托伐他汀治疗EH合并T2DM具有较好的降脂效果,可更有效地降低机体血液黏度,减轻血管损伤与血管微炎症,且安全性较高。

Objective To observe the efficacy of ezetimibe combined with atorvastatin for EH patients complicated with T2DM.Methods A total of 90 cases of EH patients complicated with T2DM admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from January 2020 to May 2022 were selected,and they were divided into the control group and the observation group according to the parity of the numbers,with 45 cases in each group.The control group was given atorvastatin calcium tablets,while the observation group was given ezetimibe tablets based on the control group,both groups were treated for 3 months.Levels of lipid indices(TC,TG,HDL-C,LDL-C),blood viscosity indices(LBV,HBV)and the other related blood biochemical indices(HCT,ESR,hs-CRP,NT-proBNP,MMP-9,IL-1β)before and after 3 months of treatment were compared between the two groups,and incidence of adverse reactions were observed of the two groups.Results After 3 months of treatment,levels of TC,TG and LDL-C in the two groups were lower than those before treatment,and HDL-C level was higher than that before treatment,and the decrease/increase in the observation group was greater than that in the control group(P<0.01);LBV,HBV in the two groups were lower than those before treatment,and the observation group were lower than those of the control group(P<0.01);HCT,ESR and serum levels of hs-CRP,NT-proBNP,MMP-9,IL-1βin the two groups were lower than those before treatment,and the observation group were lower than those in the control group(P<0.05 or P<0.01).There was no significant difference of the overall incidence of adverse reactions between the observation group and the control group(11.11%vs.13.33%,χ^(2)=0.104,P=0.748).Conclusion Ezetimibe combined with atorvastatin have better hypolipidemic effect in the treatment of EH complicated with T2DM,it can more effectively reduce patients′blood viscosity,then reduce vascular injury and vascular microinflammation,and with higher safety.