阿托伐他汀与瑞舒伐他汀对老年高血压患者颈动脉内膜中层厚度及血清ⅡA型分泌型磷脂酶A2水平的影响比较  

Effects of atorvastatin and rosuvastatin on carotid intima.media thickness and serum type Ⅱ A secretory phospholipase A2 level in elderly patients with hypertension

作　　者：穆金兴 陈要起 陈洪波 齐丽平 杨海燕[2] 

机构地区：[1]河北省邢台市第三医院心内科,054000 [2]河北省老年病医院心内科,石家庄050000

出　　处：《中国医药》2017年第5期724-727,共4页China Medicine

基　　金：河北省医学科学研究重点课题计划（20130093）

摘　　要：目的比较阿托伐他汀与瑞舒伐他汀对老年高血压患者的颈动脉内膜中层厚度（IMT）及血清ⅡA型分泌型磷脂酶A2（sPLA2ⅡA）水平的影响。方法选取2014年4月至2015年7月于河北省邢台市第三医院接受治疗的老年高血压患者90例。根据随机数字表法分为观察组及对照组，各45例。对照组给予阿托伐他汀治疗，于每晚口服10mg；观察组给予瑞舒伐他汀治疗，于每晚口服20mg；2组均连续治疗1年。比较2组治疗前后血压、颈动脉IMT、血清sPLA2IIA水平及血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇（LDL-C）水平。结果治疗后2组收缩压、舒张压及平均动脉压差异均无统计学意义（均P〉0．05）。治疗后观察组和对照组IMT均明显低于治疗前，差异均有统计学意义[（1．2±0．6）mm比（1．5±0．7）mm、（1．1±0．6）mm比（1．5±0．8）mm]（均P〈0．05）；治疗前与治疗后2组间比较差异均无统计学意义（均P〉0．05）。治疗后观察组和对照组血清sPLA2ⅡA水平分别为（3．1±0．7）、（3．2±0．8）μg/L，均明显低于治疗前的（4．3±1．1）、（4．4±1．0）μg／L，差异均有统计学意义（均P〈0．05）。治疗前与治疗后2组间比较差异均无统计学意义（均P〉0．05）。治疗前与治疗后2组血糖、总胆固醇、三酰甘油、LDL—C水平差异均无统计学意义（均P〉0．05）。结论阿托伐他汀与瑞舒伐他汀治疗老年高血压患者的疗效相当，均可有效预防患者动脉粥样硬化的发生，同时降低血清sPLA2ⅡA水平。Objective To analyze effects of atorvastatin and rosuvastatin on carotid intima-media thickness（IMT） and serum type ⅡA secretory phospholipase A2 （sPLA2Ⅱ A） in elderly patients with hypertension.Methods Totally 90 elderly patients with hypertension from April 2014 to July 2015 in Xingtai Third Hospital of Hebei Province were randomly divided into observation group and control group, with 45 cases in each group. The control group had atorvastatin （ 10 mg oral before bedtime ） ; the observation group had rosuvastatin （ 20 nag oral before bedtime） ; both groups were treated for 1 year. Blood pressure, carotid IMT, serum sPLA2 Ⅱ A, blood glucose, total cholesterol, triacylglycerol and low density lipoprotein cholesterol （LDL-C） were analyzed. Results After treatment, systolic pressure, diastolic pressure and mean arterial pressure had no significant differences between groups （P 〉 0. 05 ）. Values of IMT in observation group and control group after treatment were significantly lower than those before treatment [ （ 1.2 ± 0. 6） mm vs （ 1.5 ± 0. 7 ） mm, （ 1.1 ± 0. 6） mm vs （ 1.5 ± 0. 8 ） ] （ P 〈 0. 05 ） ; IMT had no significant differences between groups before and after treatment （ P 〉 0. 05 ）. Levels of serum sPLA2 Ⅱ A in observation group and control group after treatment were significantly lower than those before treatment[ （3.1 ±0.7）μg/L vs （4. 3 ± 1.1 ） p,g/L, （3.2 ± 0. 8） μg/L vs （4. 4 ± 1.0） μg/L] （P 〈 0. 05 ） ; serum sPLA2 Ⅱ A had no significant differences between groups before and after treatment （ P 〉 0. 05 ）. Blood glucose, total cholesterol, triacylglycerol and LDL-C had no significant differences between groups before and after treatment（ P 〉 0. 05 ）. Conclusion Atorvastatin and rosuvastatin are effective in treating hypertension in elderly patients ; both drugs can prevent the occurrence of atherosclerosis and reduce the level of serum sPLA2 Ⅱ A.

关 键 词：高血压 阿托伐他汀 瑞舒伐他汀 颈动脉内膜中层厚度 ⅡA型分泌型磷脂酶A2 

分 类 号：R544.1[医药卫生—心血管疾病]