联合治疗对腹型肥胖老年原发性高血压患者降压疗效及动脉硬化程度的影响  

Effect of Combined Therapy on Antihypertensive Effect and Degree of Arteriosclerosis in Elderly Patients with Essential Hypertension with Abdominal Obesity

作　　者：王友芳 李兴超 朱晓松 周良健 相然 张蒙蒙 车峰远[6] WANG Youfang;LI Xingchao;ZHU Xiaosong;ZHOU Liangjian;XIANG Ran;ZHANG Mengmeng;CHE Fengyuan(Intensive Care Unit of Linyi People’s Hospital,Linyi 276004,China;Scientific Research Department of Linyi People’s Hospital,Linyi 276004,China;Infection Management Department of Linyi People’s Hospital,Linyi 276004,China;Oncology Department of Linyi People’s Hospital,Linyi 276004,China;Public Health Section of Linyi People’s Hospital,Linyi 276004,China;Department of Neurologly Linyi People’s Hospital,Linyi 276004,China)

机构地区：[1]临沂市人民医院重症医学科,山东临沂276004 [2]临沂市人民医院科研科,山东临沂276004 [3]临沂市人民医院感染管理部,山东临沂276004 [4]临沂市人民医院运营管理部,山东临沂276004 [5]临沂市人民医院公共卫生科,山东临沂276004 [6]临沂市人民医院神经内科,山东临沂276004

出　　处：《湖北民族大学学报（医学版）》2023年第2期33-36,41,共5页Journal of Hubei Minzu University(Medical Edition)

基　　金：国家自然科学基金青年项目(82003435);山东省自然科学基金青年项目(ZR2020QH332);山东省医务职工科技创新计划项目(SDYWZGKCJH2022077)。

摘　　要：目的探讨氨氯地平联合阿托伐他汀钙片对腹型肥胖老年原发性高血压患者降压治疗效果及动脉硬化的影响。方法选取2020年1月-2021年10月临沂市人民医院就诊治疗的366例腹型肥胖老年原发性高血压患者,随机分为强化组207例和基础组159例。两组均给予氨氯地平(5 mg/d)进行降压治疗,强化组在此基础上给予阿托伐他汀钙片(10 mg/d)。定期随访,对两组的血压与动脉硬化相关指标进行统计学分析。结果①治疗后,组间收缩压(SBP)、脉压差(PP)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-L)较治疗前均显著降低(P<0.05)。②强化组的舒张压(DBP)显著降低(P<0.05),高密度脂蛋白胆固醇(HDL-C)显著升高(P<0.05)。③强化组的降压总有效率、动脉硬化改善的总有效率均显著高于基础组(P<0.05)。④强化组的AI显著降低,两组间的ABI均显著升高(P<0.05)。⑤治疗时两种药物对患者的SBP、DBP、PP、ABI、AI存在交互作用,F值分别为26.338、3.852、31.570、18.025、27.536,组间差异有统计学意义(P<0.05)。⑥对组别进行控制后,偏相关分析结果显示ABI与AI存在正相关(r=0.636,P<0.05)。结论氨氯地平联合阿托伐他汀钙片对腹型肥胖老年高血压者的降压疗效显著,能够有效调节血脂水平,预防和控制动脉硬化疾病的发生与发展。Objective To investigate the effect of Amlodipine combined with Atorvastatin Calcium tablets on hypertension and arteriosclerosis in elderly patients with abdominal obesity.Methods 366 elderly patients with abdominal obesity and essential hypertension who participated in physical examination in our unit from January 2020 to October 2021 were selected and randomly divided into 207 cases in the intensive group and 159 cases in the basic group.The two groups were given Amlodipine(5mg/D)for antihypertensive treatment,and the intensive group was given Atorvastatin Calcium tablets(10 mg/D).After regular follow-up,the related indexes of blood pressure and arteriosclerosis in the two groups were statistically analyzed.Results After treatment,the SBP,PP,TC,TG and LDL-C were decreased between the groups(P<0.05).Diastolic blood pressure(DBP)was significantly lower(P<0.05)and high-density lipoprotein cholesterol(HDL-C)was significantly higher(P<0.05)in the intensive group.The total effective rate of blood pressure reduction and atherosclerosis improvement were significantly higher in the intensive group than those in the basic group(P<0.05).AI was significantly lower in the intensive group,and ABI was significantly higher in both groups(P<0.05).At the time of treatment,there was an interaction between the two drugs on patients’SBP,DBP,PP,ABI,and AI,with F values of 26.338,3.852,31.570,18.025,and 27.536,respectively.The difference between groups was statistically significant(P<0.05).After controlling for groups,bias correlation analysis showed a positive correlation between ABI and AI(r=0.636,P<0.05).Conclusion Amlodiping combined with Atorvastatin Calcium tablets showed antihypertensive effect on elderly obese and hypertensive patients,which could effectively regulate blood lipid level,prevent and control the occurrence and development of atherosclerotic diseases.

关 键 词：联合治疗 老年 肥胖 高血压 动脉硬化 

分 类 号：R544.11[医药卫生—心血管疾病]