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目的分析阿托伐他汀联合氨氯地平对伴高胆固醇血症高血压患者心肌的保护作用。方法选取2012年6月—2014年5月内蒙古林业总医院收治的伴高胆固醇血症高血压患者150例,采用随机数字表法分为对照组和观察组,每组75例。对照组患者给予氨氯地平治疗,观察组患者给予阿托伐他汀联合氨氯地平治疗。比较两组患者治疗前后血压、血脂指标、血清炎性细胞因子水平和左心室质量指数(LVMI),随访1年内不良心血管事件发生情况。结果对照组患者中途剔除5例,共70例纳入分析;观察组患者中途剔除7例,共68例纳入分析。两组患者治疗前收缩压(SBP)、舒张压(DBP)比较,差异无统计学意义(P>0.05);观察组患者治疗后SBP、DBP低于对照组(P<0.05)。两组患者治疗前血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平比较,差异无统计学意义(P>0.05);观察组患者治疗后血清TC、TG、LDL-C水平低于对照组(P<0.05)。两组患者治疗前血清白介素4(IL-4)、白介素6(IL-6)水平比较,差异无统计学意义(P>0.05);观察组患者治疗后血清IL-4、IL-6水平低于对照组(P<0.05)。两组患者治疗前LVMI比较,差异无统计学意义(P>0.05);观察组患者治疗后LVMI低于对照组(P<0.05)。两组患者随访1年内不良心血管事件发生率比较,差异无统计学意义(P>0.05)。结论阿托伐他汀联合氨氯地平可有效降低伴高胆固醇血症高血压患者血压、血脂指标及血清炎性因子水平,具有一定的心肌保护作用,且安全性较高。
Objective To analyze the protective effect of atorvastatin combined with amlodipine on myocardium in hypertensive patients with hypercholesterolemia. Methods 150 patients with hypercholesterolemia admitted to Inner Mongolia Forestry General Hospital from June 2012 to May 2014 were randomly divided into control group and observation group with 75 cases in each group. Patients in the control group were treated with amlodipine, and patients in the observation group were given atorvastatin combined with amlodipine. Blood pressure, blood lipid, serum levels of inflammatory cytokines and left ventricular mass index (LVMI) were compared between the two groups before and after treatment. The incidence of adverse cardiovascular events within one year of follow-up was compared. Results In the control group, 5 patients were excluded halfway, and 70 patients were included in the analysis. Among the patients in the observation group, 7 patients were removed halfway and 68 patients were included in the analysis. SBP and DBP in the two groups had no significant difference before treatment (P> 0.05). SBP and DBP in the observation group were lower than those in the control group after treatment (P <0.05). The levels of total cholesterol (TC), triglyceride (TG), and low density lipoprotein cholesterol (LDL-C) in two groups before treatment were not significantly different (P> 0.05) , TG, LDL-C levels were lower than the control group (P <0.05). The levels of serum IL-4 and IL-6 in the two groups before treatment were not significantly different (P> 0.05). The levels of IL-4 and IL-6 in the observation group were lower after treatment In the control group (P <0.05). There was no significant difference in LVMI between the two groups before treatment (P> 0.05). The LVMI of the observation group was lower than that of the control group after treatment (P <0.05). There was no significant difference in the incidence of adverse cardiovascular events between the two groups within one year of follow-up (P> 0.05). Conclusions Atorvastatin combined with amlodipine can effectively reduce the blood pressure, blood lipid and serum levels of inflammatory cytokines in hypertensive patients with hypercholesterolemia, and has certain myocardial protective effect and high safety.