摘要
目的分析甲钴胺联合阿托伐他汀治疗H型高血压患者的临床来疗效及其对内质网应激标志蛋白和颈动脉内膜中层厚度(CIMT)的影响。方法选取攀钢集团总医院2016年10月-2018年8月收治的H型高血压患者120例,采用随机数字表法分为对照组与观察组,每组60例。在常规降压治疗基础上,对照组患者给予阿托伐他汀钙治疗,观察组患者给予甲钴胺+阿托伐他汀钙治疗;两组患者均持续治疗3个月。比较两组患者临床疗效,治疗前后炎性因子〔包括白介素1β(IL-1β)、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)〕、血管内皮功能指标〔包括内皮素(ET)、一氧化氮(NO)〕水平、同型半胱氨酸(Hcy)水平、内质网应激标志蛋白〔包括肌醇依赖酶1α(IRE1α)、内质网氧化还原酶1-Lα(Ero1-Lα)、蛋白激酶R样内质网激酶(PERK)、免疫球蛋白重链结合蛋白(BiP)〕水平、CIMT,并观察两组患者治疗期间不良反应发生情况。结果(1)与对照组比较,观察组患者临床疗效较好(P<0.05)。(2)对照组与观察组患者治疗前IL-1β、IL-6、TNF-α水平比较,差异无统计学意义(P>0.05);与对照组比较,观察组患者治疗后IL-1β、IL-6、TNF-α水平降低(P<0.05)。(3)对照组与观察组患者治疗前ET、NO、Hcy水平比较,差异无统计学意义(P>0.05);与对照组比较,观察组患者治疗后ET、Hcy水平降低,NO水平升高(P<0.05)。(4)对照组与观察组患者治疗前IRE1α、Ero1-Lα、PERK、BiP水平比较,差异无统计学意义(P>0.05);与对照组比较,观察组患者治疗后IRE1α、Ero1-Lα、PERK、BiP水平降低(P<0.05)。(5)对照组与观察组患者治疗前CIMT比较,差异无统计学意义(P>0.05);与对照组比较,观察组患者治疗后CIMT减小(P<0.05)。(6)对照组与观察组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论甲钴胺联合阿托伐他汀治疗H型高血压患者的临床疗效较好,可有效减轻患者炎性反应,改善患者血管内皮功能,降低Hcy水平、内质网应激标志蛋白水平及CIMT,且安全性较高。
Objective To analyze the clinical effect of mecobalamine combined with atorvastatin in the treatment of H-type hypertension and the impact on endoplasmic reticulum stress marker proteins and carotid intima-media thickness(CIMT).Methods A total of 120 patients with H-type hypertension were selected in General Hospital of PanGang Group from October 2016 to August 2018,and they were divided into control group and observation group according to random number table method,with 60 cases in each group.Based on routine antihypertensive therapy,patients in control group were treated with atorvastatin,while patients in observation group were treated with mecobalamine combined with atorvastatin;both groups were continuously treated for 3 months.Clinical effect,pre-and post-treatment inflammatory cytokines(including IL-1β,IL-6,TNF-α),indicator of vascular endothelial function(including ET and NO),Hcy,endoplasmic reticulum stress marker proteins(including IRE1α,Ero1-Lα,PERK and BiP)and CIMT were compared between the two groups,and incidence of adverse reactions was observed during treatment.Results(1)Clinical effect in observation group was statistically significantly better than that in control group(P<0.05).(2)Compared with those in control group,observation group showed similar IL-1β,IL-6 and TNF-αbefore treatment(P>0.05),but statistically significantly lower IL-1β,IL-6 and TNF-αafter treatment(P<0.05).(3)Compared with those in control group,observation group showed similar ET,NO and Hcy before treatment(P>0.05),but statistically significantly lower ET and Hcy,higher NO after treatment(P<0.05).(4)Compared with those in control group,observation group showed similar IRE1α,Ero1-Lα,PERK and BiP before treatment(P>0.05),but statistically significantly lower IRE1α,Ero1-Lα,PERK and BiP after treatment(P<0.05).(5)Compared with that in control group,observation group showed similar CIMT before treatment(P>0.05),but statistically significantly thinner CIMT after treatment(P<0.05).(6)Compared with that in control group,observation group showed similar incidence of adverse reactions during treatment(P>0.05).Conclusion Mecobalamine combined with atorvastatin are significantly effective in treating patients with H-type hypertension,which can effectively relieve the inflammatory reaction,improve the vascular endothelial function,reduce the Hcy,endoplasmic reticulum stress marker proteins and CIMT,with relatively high safety.
作者
李涛
李靓
杨景美
LI Tao;LI Liang;YANG Jingmei(Department of Cardiovascular Medicine,General Hospital of PanGang Group,Panzhihua 617000,China)
出处
《实用心脑肺血管病杂志》
2019年第10期91-94,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
H型高血压
甲钴胺
阿托伐他汀
颈动脉内膜中层厚度
内质网应激
H-type hypertension
Mecobalamine
Atorvastatin
Carotid intima-media thickness
Endoplasmic reticulum stress
作者简介
通信作者:李涛,E-mail:3391124328@qq.com。
