上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

阿托伐他汀对高血压合并血脂异常患者的疗效及对机体炎症反应的影响

黄海源1，潘兴寿1，黄显南1，周柳芳1，刘 燕1，罗 薇1，符黄德2   

  1. 右江民族医学院附属医院 1.心血管内科， 2.神经外科， 百色 533000
  • 出版日期:2014-11-28 发布日期:2014-12-02
  • 通讯作者: 符黄德, 电子信箱: fuhuangde@126.com。
  • 作者简介:黄海源（1980—），女，侗族，主治医师，硕士生; 电子信箱: haiyuanhuangbs@163.com。

Effects of atorvastatin on hypertension patients with dyslipidemia and body's inflammatory response

HUANG Hai-yuan1, PAN Xing-shou1, HUANG Xian-nan1, ZHOU Liu-fang1, LIU Yan1, LUO Wei1, FU Huang-de2   

  1. 1.Department of Cardiovascular Medicine, 2.Department of Neurosurgery，the Affiliated Hospital of Youjiang Medical University for Nationalities， Baise 533000, China
  • Online:2014-11-28 Published:2014-12-02

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摘要：

目的 探讨阿托伐他汀对高血压合并血脂异常患者的临床疗效及其对机体炎症反应的影响。方法 选取120例高血压合并血脂异常的患者为研究对象，随机分为联合用药组（联合组）和单独用药组（单独组），每组各60例，同时匹配选择60名同期接受体检的健康志愿者为对照组。单独组患者仅使用苯磺酸左旋氨氯地平片（2.5 mg/d），联合组患者则在此基础之上加用阿托伐他汀（20 mg/d），疗程8周。比较两种治疗方案的降压效果及其对血脂水平、颈-股动脉脉搏波传导速度（cfPWV）及血清hs-CRP、MMP-9及炎症细胞因子水平的影响。结果 治疗后2组患者的高血压病情均得到不同程度的控制和改善，其中联合组的显效和有效例数为58例，总体有效率为96.67%；单独组显效和有效例数为44例，总体有效率为73.33%，明显低于联合组（P<0.05）。与治疗前比较，联合组和单独组治疗后的血清总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、白介素-4 （IL-4）、IL-6、MMP-9和hs-CRP水平及cfPWV均明显降低，血清高密度脂蛋白胆固醇（HDL-C）和IL-10水平则显著升高（P<0.05），且联合组上述指标的改变明显优于单独组（P<0.05）。血压值与IL-4、IL-6、MMP-9、hs-CRP及cfPWV呈显著正相关，与IL-10呈显著负相关。结论 阿托伐他汀对高血压合并血脂异常患者的临床疗效显著，且可有效抑制机体的炎症反应。

关键词: 阿托伐他汀, 高血压, 高敏C-反应蛋白, 基质金属蛋白酶-9, 炎症细胞因子

Abstract:

Objective To investigate the effects of atorvastatin on hypertension patients with dyslipidemia and body's inflammatory response. Methods A total of 120 hypertension patients with dyslipidemia were selected and randomly divided into the combined drug group (n=60) and single drug group (n=60) and 60 healthy volunteers were selected as the control group. Patients of the single drug group administrated levamlodipine besylate tablets (2.5 mg/d) and patients of the combined drug group administrated same dose of levamlodipine besylate tablets and atorvastatin (20 mg/d) for 8 weeks. The effects of two therapeutic regimens on the anti-hypertension, blood lipid level, carotid-femoral pulse wave velocity (cfPWV), serum high-sensitivity C-reactive protein (hs-CRP) level, serum matrix metalloproteinase-9 (MMP-9) level, and serum inflammatory cytokine level were compared. Results Symptoms of hypertension of two groups were controlled and improved at different degrees after treatment. Fifty-eight cases of the combined drug group were markedly effective or effective and the overall response rate was 96.67%, while 44 cases of the single drug group were markedly effective or effective and the overall response rate was 73.33%, which was significantly lower than that of the combined drug group (P<0.05). The TC, TG, LDL-C, IL-4, IL-6, MMP-9, and hs-CRP levels and cfPWV of two groups significantly decreased after treatment, while HDL-C and IL-10 levels significantly increased in both groups (P<0.05). Variations of above indexes of the combined drug group were significantly superior than those of the single drug group (P<0.05). The blood pressure values significantly and positively correlated to IL-4, IL-6, MMP-9, hs-CRP, and cfPWV, while significantly and negatively correlated to IL-10. Conclusion Atorvastatin has significant clinical effects on hypertension patients with dyslipidemia and can efficiently inhibit the body's inflammatory response.

Key words: atorvastatin, hypertension, high-sensitivity C-reactive protein, matrix metalloproteinase-9, inflammatory cytokine