长期抗压联合阿托伐他汀对伴高胆固醇血症高血压患者心肌的保护作用  

Protective effect of long-term anti-hypertension combined with atorvastatin on myocardium in hypertensive patients with high cholesterol

作　　者：时培苗[1] 张成国 

机构地区：[1]山东省滕州市中心人民医院心内一科,277500 [2]山东省枣庄市山亭区人民医院内三科,277200

出　　处：《中国实用医刊》2017年第16期4-6,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨长期抗压联合阿托伐他汀治疗对伴高胆固醇血症高血压患者的心肌保护作用。方法将95例伴高胆固醇血症高血压患者随机分为对照组（n=40）和治疗组（n=55）。对照组给予氨氯地平长期降压治疗，治疗组在对照组的基础上联合阿托伐他汀治疗。比较两组治疗前后血压变化情况和血浆总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）和高密度脂蛋白胆固醇（HDL—C）水平，比较两组左心室射血分数（LVEF）、血浆脑钠钛（BNP）、氨基末端B型利钠肽前体（NT—proBNP）水平，评估心肌保护作用，并随访6个月观察两组心肌不良事件发生情况。结果两组治疗前血压、胆固醇比较差异未见统计学意义（P〉0．05），治疗后治疗组收缩压、舒张压均显著低于对照组（P〈0．05），TC、LDL—C水平均显著低于对照组（P〈0．05）。治疗前两组各项心肌保护作用指标水平比较差异未见统计学意义（P〉0．05），治疗后治疗组BNP、NT—proBNP均显著低于对照组，LVEF显著高于对照组（P〈0．05）。治疗组心肌不良事件发生率（3．64％）明显低于对照组（22．50％）（P〈0．05）。结论阿托伐他汀可降低伴高胆固醇血症高血压患者的血压、胆固醇水平，并对心肌有显著保护作用，可有效降低心肌功能指标及降低左心室肥厚、心肌供血不足、心肌梗死等不良事件的发生风险。Objective To investigate the protective effect of long-term anti-hypertension com- bined with atorvastatin on myocardium in hypertensive patients with high cholesterol. Methods Ninety- five hypertensive patients with high cholesterol were randomly divided into control group （n = 40 ） and treatment group （n = 55）. The control group was treated by long-term anti-hypertension with amlodipine. On the basis, the treatment group was treated with atorvastatin. Changes of blood pressure before and af- ter treatment, the levels of total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C） and high- density lipoprotein cholesterol （HDL-C） were compared between the two groups. The levels of left ventrieular ejection fraction （LVEF）, plasma brain natriuretic titanium （BNP） and N-terminal pro-B-type natriuretic peptide （NT-proBNP） were also compared, and the protection effect on myocardium was evaluated. All patients were followed up for 6 months to observe the incidence of cardiac adverse events in the two groups. Results There were no significant differences in blood pressure or cholesterol between the two groups before treatment （P 〉 0.05）. After treatment, the systolic blood pressure and diastolic blood pressure of treatment group were significantly lower than those of control group （P 〈 0. 05 ） , and the levels of TC and LDL-C in treatment group were significantly lower than those in control group （ P 〈 0.05 ）.There were no significant differences in indexes of myocardial protection effect between the two groups be- fore treatment （P 〉 0. 05 ）. After treatment, BNP and NT-proBNP in the treatment group were significantly lower than those in control group, while LVEF was significantly higher （ P 〈 0. 05 ）. The incidence rate of adverse events in the treatment group （3.64%） was significantly lower than that in the control group （22.50%） （P 〈 0. 05 ）. Conclusions Atorvastatin can reduce blood pressure and cholesterol levels in patients, and

关 键 词：阿托伐他汀 胆固醇 高血压 心肌 

分 类 号：R544.1[医药卫生—心血管疾病] R589.2[医药卫生—内科学]