阿托伐他汀对老年轻度高血压合并动脉粥样硬化患者疗效及动态血压分析  

The effect of Atorvastatin in elderly mild hypertensive patients with atherosclerosis and analysis of ambulatory blood

作　　者：刘波[1] 韩冷[1] 曹东来[1] 何文兵[1] 何俊[1] LIU Bo HAN Leng CAO Dong-lai et al(Cardiovascular Medicine, Changshu NO.1 People＇s Hospital, Changshu 215500, China)

机构地区：[1]常熟市第一人民医院心内科,江苏省常熟市215500

出　　处：《中国心血管病研究》2016年第8期739-743,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨阿托伐他汀对老年轻度高血压合并动脉粥样硬化患者疗效及其动态血压特征分析.方法 选择2011年3月至2014年1月常熟市第一人民医院收治的414例老年轻度高血压合并动脉粥样硬化患者,按就诊单双号随机分为对照组（常规治疗,202例）和观察组（常规治疗＋阿托伐他汀,212例）.两组患者均连续治疗24个月,比较两组治疗前后颈动脉粥样硬化斑块面积、颈动脉内膜中层厚度（IMT）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、氧化低密度脂蛋白（ox-LDL）水平变化及动态血压情况.结果 与治疗前比较,对照组和观察组IMT、颈动脉内膜斑块面积、TG、TC、LDL、ox-LDL水平均显著降低（P＜0.05）,HDL水平则显著升高（P＜0.05）;动态血压各项参数24h、昼间、夜间的平均收缩压、平均舒张压、平均动脉压均显著降低（P＜0.05）.治疗后与对照组比较,观察组A、B、C组的颈动脉内膜斑块面积（21.63±2.28）mmm2、（20.02±2.14）mm2、（18.12±2.01）mm2与颈动脉IMT（1.19±0.18）mmm、（1.05±0.17）mmm、（1.01 ±0.09）mmm,TG、TC、LDL、ox-LDL水平均显著降低（P＜0.05）,HDL水平显著升高（1.55±0.34）mmol/L、（1.78±0.31）mmol/L、（1.92±0.39）mmol/L（P＜0.05）;24h、昼间、夜间的平均收缩压,平均舒张压,平均动脉压均显著降低（P.＜0.05）.颈动脉内膜斑块面积与颈动脉IMT、TG、TC、LDL、ox-LDL水平、24h、昼间和夜间的平均收缩压、平均舒张压、平均动脉压,观察组C组较A组明显降低,HDL明显升高,但A组与B组、B组与C组未见统计学差异（P＞0.05）.结论 阿托伐他汀联合抗高血压药物对于老年轻度高血压合并动脉粥样硬化患者疗效显著,低危因素情况可以考虑10 mg/次,1次/d,高危因素可以考虑30 mmg/次,1次/d,有益于血压的控制,适于老年高血压合并动脉粥样硬化患者长期服用.Objective To investigate the efficacy of Atorvastatin in elderly hypertensive patients with atherosclerosis, and to explore its dynamic characteristics of blood pressure. Methods A total of 414 elderly mild hypertensive patients with atherosclerosis from March 2011 to January 2014 in our hospital were selected. They were randomly divided into control group （conventional treatment, 202 cases） and observation group （conventional treatment＋Atorvastatin, 212 cases）. Patients were given 24 months of continuous therapy. The carotid atherosclerotic plaque area, carotid intima-media thickness of IMT, blood lipids （triglycerides TG, total cholesterol TC, high density lipoprotein HDL, low-density lipoprotein LDL, oxidized low-density lipoprotein ox-LDL） levels and dynamic changes in blood pressure before and after the treatment were compared. Results Compared with before treatment, IMT and carotid intima plaque area, TG, TC, LDL, ox-LDL levels, ambulatory blood pressure parameters of 24 h, daytime, nighttime mean systolic blood pressure, mean diastolic blood pressure, mean arterial pressure of the two groups were significantly lower（P〈0.05）, HDL levels were significantly increased（P〈0.05）. After treatment compared with the control group, the carotid intima carotid plaque area（21.63±2.28）mm2, （20.02±2.14） mm2, （ 18.12±2.01 ）mm2 and IMT （ 1.19±0.18）mm, （ 1.05±0.17）mm, （1.01±0.09）mm, TG, TC, LDL, ox-LDL levels, 24 h, daytime, nighttime mean systolic blood pressure, mean diastolic blood pressure, mean arterial pressure of the observation A, B, C group were significantly lower （P〈0.05）, HDL levels significantly higher （1.55± 0.34 ）mmol/L, （ 1.78±0.31 ）mmol/L, （ 1.92±0.39 ）mmol/L（P〈0.05 ）. IMT and carotid intima plaque area, TG, TC, LDL, ox-LDL levels, ambulatory blood pressure parameters of 24 h, daytime, nighttime mean systolic blood pressure, mean diastolic blood pressure, mean arterial pressure of observation C group were significantly lower t

关 键 词：阿托伐他汀 高血压 动脉粥样硬化 动态血压 

分 类 号：R544.1[医药卫生—心血管疾病]