降脂治疗对肾动脉粥样硬化性高血压患者的临床疗效  

The clinical efficacy of lipid-lowering therapy for patients with renal atherosclerosis hypertension

作　　者：庞广杰[1] 李彤[2] 袁天阳[3] 刘洋[1] 田卫东[1] 李俊[1] 姜雪婷[1] 张静[1] PANG Guang-jie;LI Tong;YUAN Tian-yang;LIU Yang;TIAN Wei-dong;LI Jun;JIANG Xue-ting;ZHANG Jing(Department of cardiology, Second Affiliated Hospital of Jilin University, 130041, China)

机构地区：[1]吉林大学第二医院心血管内科,长春130041 [2]吉林大学第二医院彩超室,长春130041 [3]延边大学,延边133000

出　　处：《中国循证心血管医学杂志》2016年第6期724-726,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的观察降脂治疗对肾动脉粥样硬化性高血压患者的临床疗效。方法选择28例经肾动脉彩超明确诊断为肾动脉粥样硬化性高血压的患者,给予降压药物的同时应用阿托伐他汀钙降脂治疗1年。观察血脂、炎症因子、肝功能、肌酸激酶、肾动脉收缩期峰值速度(PSV)及肾动脉峰值流速与肾动脉开口处腹主动脉流速之比(RAR)等指标的变化。结果患者总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)、氧化型低密度脂蛋白(OX-LDL)水平随用药时间的延长均明显降低,差异有统计学意义(P<0.05)。LDL的降低水平与PSV、RAR的降低水平呈正相关(r=0.288、0.061,P<0.05);OX-LDL的降低水平与PSV、RAR的降低水平呈正相关(r=0.250、0.121,P<0.05)。应用阿托伐他汀降脂治疗后炎症因子(MMP-2、MMP-9及CRP)水平均随着用药时间的延长而明显下降,差异有统计学意义(P<0.05)。降脂治疗后ALT、AST及CK水平的变化无显著统计学差异(P>0.05)。结论小样本研究显示降脂治疗对肾动脉粥样硬化性狭窄有控制作用,安全性良好。Objective To observe the clinical efficacy of lipid-lowering therapy for patients with renalatherosclerosis hypertension. Methods We selected 28 patients diagnosed as renal atherosclerosis hypertensionby renal artery ultrasound. All patients were given antihypertensive drugs and atorvastatin for 1 year. We observedblood lipids, inflammatory factors, liver function, creatine kinase, renal artery peak systolic velocity (PSV) andrenal artery and abdominal aortic peak systolic velocity ratio (RAR). Results The levels of total cholesterol (TC),triglyceride (TG), low density lipoprotein (LDL-C), oxidized low density lipoprotein (OX-LDL) were significantlylower with the extension of treatment time, the difference was statistically significant (P<0.05). The LDL-Creduction was positively correlated with PSV, and RAR change (r=0.288, and 0.061, P<0.05). The OX-LDLreduction was positively correlated with PSV, and RAR change (r=0.250, and 0.121, P<0.05). After the lipidloweringtherapy with atorvastatin, the levels of inflammatory factors (MMP-2, MMP-9 and CRP) were decreasedobviously, the difference was statistically significant (P<0.05). The changes of ALT, AST and CK were notstatistically different (P>0.05) after the lipid-lowering therapy. Conclusion The lipid-lowering therapy cancontrol atherosclerotic renal artery stenosis, and shows good security.

关 键 词：肾动脉粥样硬化 肾动脉狭窄性高血压 他汀类药物 炎症因子 

分 类 号：R544.14[医药卫生—心血管疾病]