摘要
目的探讨不同剂量阿托伐他汀钙治疗对冠心病合并高血压患者血脂、血管内皮功能及动态血压水平的影响。方法选取2017年1月至2020年1月于西安理工大学医院门诊就诊的106例冠心病合并高血压患者,按照随机数表法分为常规组和强化组,每组53例。两组患者的治疗方案均为氨氯地平+阿托伐他汀钙,其中常规组患者的阿托伐他汀钙剂量为20 mg/d,强化组为40 mg/d。用药1个月后,比较两组患者的血脂[三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)]、血管内皮功能[一氧化氮(NO)、内皮素-1(ET-1)]、动脉血压[24 h平均收缩压(24 h SBP)、24 h平均舒张压(24 h DBP)、收缩压变异性(SBPV)、舒张压变异性(DBPV)];同时记录两组治疗过程中的不良反应发生情况。结果治疗后,强化组患者的TG、TC、LDL-C水平分别为(1.59±0.37)mmol/L、(3.28±0.72)mmol/L、(1.53±0.30)mmol/L,明显低于常规组的(2.03±0.42)mmol/L、(4.11±0.75)mmol/L、(1.82±0.39)mmol/L,HDL-C水平为(1.54±0.31)mmol/L,明显高于常规组的(1.30±0.26)mmol/L,差异均有统计学意义(P<0.05);治疗后,强化组患者的NO水平为(16.52±3.51)mmol/L,明显高于常规组的(12.39±2.86)mmol/L,ET-1水平为(63.05±7.28)mmol/L,明显低于常规组的(70.14±8.00)mmol/L,差异均有统计学意义(P<0.05);治疗后,强化组患者24 h的SBP、24 h DBP、SBPV、DBPV明显低于常规组,差异均有统计学意义(P<0.05);强化组与常规组患者的不良反应总发生率分别为22.64%、16.98%,差异无统计学意义(P>0.05)。结论高剂量的阿托伐他汀钙治疗冠心病合并高血压能更好地调脂、改善血管内皮功能、控制血压,而且不会增加药物的不良反应,其临床治疗效果优于常规剂量。
Objective To investigate the effects of different doses of atorvastatin calcium on blood lipids,vascular endothelial function and ambulatory blood pressure levels in patients with coronary heart disease and hypertension.Methods A total of 106 patients with coronary heart disease and hypertension who were treated in the outpatient clinic of School Hospital at Xi’an University of Technology from January 2017 to January 2020 were selected and divided into a routine group and an intensive group according to the random number table method,with 53 cases in each group.Both groups were treated with amlodipine plus atorvastatin calcium.The dose of atorvastatin calcium was 20 mg/d in the routine group and 40 mg/d in the intensive group.After one month of treatment,the blood lipids indexes[triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)],vascular endothelial function indexes[nitric oxide(NO),endothelin-1(ET-1)],and arterial blood pressure indexes[24-h mean systolic blood pressure(24 h SBP),24-h mean diastolic blood pressure(24 h DBP),systolic blood pressure variability(SBPV),and diastolic blood pressure variability(DBPV)]were compared between the two groups of patients;at the same time,the adverse reactions were recorded during the treatment of the two groups.Results After treatment,the levels of TG,TC,and LDL-C in the intensive group were significantly lower than those in the routine group,i.e.TG(1.59±0.37)mmol/L vs(2.03±0.42)mmol/L;TC(3.28±0.72)mmol/L vs(4.11±0.75)mmol/L;LDL-C(1.53±0.30)mmol/L vs(1.82±0.39)mmol/L;and the HDL-C level in the intensive group was significantly higher than that in the routine group:(1.54±0.31)mmol/L vs(1.30±0.26)mmol/L,and all differences were statistically significant(P<0.05).After treatment,the NO level in the intensive group was(16.52±3.51)mmol/L,significantly higher than(12.39±2.86)mmol/L in the routine group,and the ET-1 level of the intensive group was(63.05±7.28)mmol/L,significantly lower than(70.14±8.00)mmol/L in the routine group;all differences were statistically significant(P<0.05).After treatment,the 24 h SBP,24 h DBP,SBPV and DBPV of the intensive group were significantly lower than those of the routine group(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the intensive group(22.64%)and the routine group(16.98%),P>0.05.Conclusion High-dose atorvastatin calcium can better regulate lipids,improve vascular endothelial function,and control blood pressure in treating coronary heart disease with hypertension,and will not increase adverse drug reactions.Its clinical therapeutic effect is better than that of routine dose.
作者
宋晓燕
张毅
雷小宝
费利霞
王丽萍
SONG Xiao-yan;ZHANG Yi;LEIXiao-bao;FEI Li-xia;WANG Li-ping(Department of Pharmacy,School Hospital,Xi'an University of Technology,Xi'an 710048,Shaanxi,CHINA;Department of Internal Medicine,School Hospital,Xi'an University of Technology,Xi'an 710048,Shaanxi,CHINA;Department of Cardiology,Honghui Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710054,Shaanxi,CHINA)
出处
《海南医学》
CAS
2021年第21期2736-2739,共4页
Hainan Medical Journal
关键词
阿托伐他汀钙
冠心病
高血压
血脂
血管内皮功能
动态血压
Atorvastatin calcium
Coronary heart disease
Hypertension
Blood lipids
Vascular endothelial function
Ambulatory blood pressure
作者简介
通讯作者:王丽萍,E-mail:heart-wang@163.com。
