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目的研究临床应用氨氯地平阿托伐他汀钙片治疗高血压冠心病合并颈动脉粥样硬化的疗效。方法 100例高血压冠心病合并颈动脉粥样硬化患者作为研究对象,根据治疗方法不同分为对照组与观察组,各50例。对照组患者采用氨氯地平片进行治疗,观察组患者采用氨氯地平阿托伐他汀钙片进行治疗,对比两组治疗效果。结果观察组患者降压治疗总有效率为96.00%,对照组为94.00%,两组降压治疗总有效率均较高,比较差异无统计学意义(P>0.05)。相对于治疗前,观察组与对照组两组患者治疗后的肿瘤坏死因子(TNF)-α、超敏C反应蛋白(hs-CRP)水平均显著降低(P<0.05),且观察组患者的降低幅度更加明显(P<0.05)。相对于治疗前,观察组患者治疗后的低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、总胆固醇(TC)水平均显著降低,高密度脂蛋白胆固醇(HDL-C)则显著升高,差异均具有统计学意义(P<0.05),且治疗后观察组各项血脂指标均明显优于对照组(P<0.05)。对照组患者治疗后的各血脂指标水平与治疗前比较差异无统计学意义(P>0.05)。治疗后,两组患者的颈动脉内膜中层厚度(IMT)相对于治疗前明显下降,且观察组降低更明显(P<0.05)。相对于治疗前,两组患者治疗后的颈动脉粥样硬化斑块体积(PV)均显著下降(P<0.05),但组间比较,差异无统计学意义(P>0.05)。观察组不良反应发生率为8.00%,对照组不良反应发生率为6.00%,两组不良反应发生率均较低,比较差异无统计学意义(P>0.05)。结论临床应用氨氯地平阿托伐他汀钙片治疗高血压冠心病合并颈动脉粥样硬化的疗效显著,且可明显改善患者血脂水平,值得广泛推广。
Objective To study the clinical efficacy of amlodipine atorvastatin calcium in the treatment of patients with hypertensive coronary heart disease complicated with carotid atherosclerosis. Methods One hundred cases of hypertensive coronary heart disease with carotid atherosclerosis were divided into control group and observation group with 50 cases in each group. Patients in the control group were treated with amlodipine tablets. Patients in the observation group were treated with amlodipine atorvastatin calcium tablets, and the treatment effect was compared between the two groups. Results In the observation group, the total effective rate of antihypertensive treatment was 96.00% and that of the control group was 94.00%. The total effective rate of antihypertensive treatment was higher in both groups, with no significant difference (P> 0.05). The levels of TNF-α and hs-CRP in the two groups were significantly lower than those before treatment (P <0.05), and the levels of TNF-α and hs-CRP in the observation group and the control group were significantly decreased The decrease was more obvious (P <0.05). Compared with those before treatment, the levels of LDL-C, TG and TC in the observation group were significantly decreased, and the levels of HDL-C (P <0.05). After treatment, all the indexes of blood lipid in the observation group were significantly better than those in the control group (P <0.05). The level of serum lipids in the control group after treatment was not significantly different from that before treatment (P> 0.05). After treatment, carotid artery intima-media thickness (IMT) in both groups decreased significantly compared with that before treatment, and the decrease in the observation group was more obvious (P <0.05). Before treatment, carotid atherosclerotic plaque volume (PV) decreased significantly in both groups (P <0.05), but there was no significant difference between groups (P> 0.05). The incidence of adverse reactions in the observation group was 8.00%, the incidence of adverse reactions in the control group was 6.00%, and the incidence of adverse reactions in both groups was low, with no significant difference (P> 0.05). Conclusion The clinical application of amlodipine atorvastatin calcium tablets in the treatment of patients with hypertensive coronary heart disease with carotid atherosclerosis has significant curative effect, and can significantly improve the level of blood lipid in patients, which deserves to be widely promoted.