强化降脂治疗对高血压合并高脂血症患者动脉脉搏波传导速度的影响  

Effect of Artery Pulse Wave Velocity by Intensive Lipid-lowering Therapy in Patients with Hypertension Combined Hyperlipidemia

作　　者：廖奕华 邓云梅 胡晶晶 马艳丽 樊琳 

机构地区：[1]解放军第四五七医院,湖北武汉430012

出　　处：《中国医学创新》2013年第21期6-8,共3页Medical Innovation of China

摘　　要：目的:观察强化降脂治疗对高血压合并高脂血症患者动脉脉搏波传导速度的影响。方法:99例1、2级高血压病合并高脂血症患者随机分为强化降脂组50例和对照组49例,两组患者降压治疗均选用硝苯地平缓释片、缬沙坦;使患者血压降至140/90mmHg以下。降脂治疗选用阿托伐他汀钙,对照组血脂水平降至TC<5.18mmol/L、LDL-C<3.37mmol/L;强化降脂组血脂水平降至TC<4.11mmol/L、LDL-C<2.60mmol/L;疗程均为6个月。观察治疗前后患者血压、臂踝动脉脉搏波传导速度(baPWV)、血脂、高敏C反应蛋白(hs-CRP)和血浆内皮素(ET)的变化。结果:与正常值相比,两组患者baPWV、ET、hs-CRP水平均明显升高,比较差异均有统计学意义(P<0.01),治疗6个月后有明显回落(P<0.01),其中强化降脂组治疗后降低更为明显,两组比较差异有统计学意义(P<0.05)。结论:对轻中度高血压合并高脂血症患者,在控制血压基础上,强化降脂治疗,可进一步改善患者的臂踝动脉脉搏波传导速度、降低hs-CRP和ET水平,对改善患者的血管功能状态有积极临床意义。Objective： To observe the effect of pulse wave velocity by intensive lipid-lowering therapy in patients with hypertension combined hyperlipidemia.Method： 100 cases of hypertension grade 1 and 2 combined with hyperlipidemia were randomly divided into 49 cases of control group and 50 cases intensive lipid-lowering group.Antihypertensive treatment with nifedipine in both groups, valsartan （ blood pressure drop to below 140/90 mm Hg ） ; Lipid-lowering therapy with atorvastafin calcium, the lipid levels was： TC〈5.00 mmol/L, LDL-C〈3.1 mmol/L in control group, and TC〈4.11 mmol/L, LDL-C〈2.6 mmol/L in intensive lipid-lowering group.The course of treatment was six months, the artery pulse wave velocity （ baPWV ）, blood pressure, total cholesterol （ TC ）, triglyceride （ TG ）, high density lipoprotein cholesterol （ HDL-C ）, low density lipoprotein （ LDL-C ）, high sensitive C reactive protein （ hs-CRP ） and endothelin （ ET ） were detected before and after treatment.Result： Compared with normal group, two groups of patients baPWV, hs-CRP and ET levels were significantly elevated, with significant difference （ P〈0.01 ）, and it retreated significantly after 6 months treatment （ P〈0.01 ）; compared with control group, which of intensive lipid-lowering group was decreased obviously, the difference was statistically significant between the groups （P〈0.05） .Conclusion： Patient with mild-to-moderate hypertension combined hyperlipidemia, intensive lipid-lowering therapy based on the control of blood pressure can futher improve the brachial-ankle artery pulse wave velocity, decreased hs-CRP and ET levels in patients, to improve the state of vascular function with a positive clinical significance.

关 键 词：脉搏波传导速度 高敏C反应蛋白 内皮素 高血压病 高脂血症 

分 类 号：R544.1[医药卫生—心血管疾病]