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目的研究使用阿托伐他汀联合依折麦布与单用阿托伐他汀强化降脂对高血压合并糖尿病患者低密度脂蛋白胆固醇(LDL-C)、氨基末端脑钠肽前体(NT-proBNP)、基质金属蛋白酶-9(MMP-9)及高敏C反应蛋白(hsCRP)血浆浓度的影响以及MMP-9与hsCRP、NT-proBNP的相关性。方法在河北联合大学附属唐山市人民医院确诊的高血压合并糖尿病,同时具有高脂血症的患者86人随机分成2组。观察组42例,采用饮食控制加阿托伐他汀20 mg联合依折麦布10 mg;对照组44人采用饮食控制加阿托伐他汀40 mg,均治疗12周后比较2组之间LDL-C,NT-proBNP和MMP-9、hsCRP血浆浓度的变化。采用Pearson直线相关分析MMP-9与hsCRP和NT-proBNP的相关性。结果观察组LDL-C、hsCRP、MMP-9降低明显(P<0.05),对照组NT-proBNP较观察组改善明显(P<0.05)。MMP-9与hsCRP具有明显的正相关性(r=0.352,P=0.001),而与NT-proBNP水平无相关性(r=-0.060,P=0.584)。结论阿托伐他汀联合依折麦布组较阿托伐他汀单药组更能降低LDL-C及控制炎症反应;阿托伐他汀组较阿托伐他汀联合依折麦布组对NT-proBNP影响更明显。MMP-9与hsCRP具有明显的正相关,表明MMP-9是一个炎症因子,不是评价心功能的指标。
Objective To investigate the effects of atorvastatin combined with ezetimibe and atorvastatin on lipid lowering in patients with hypertension and low-density lipoprotein cholesterol (LDL-C), N-terminal proBNP (NT-proBNP) ), Matrix metalloproteinase-9 (MMP-9) and high-sensitivity C-reactive protein (hsCRP) in plasma and the correlation between MMP-9 and hsCRP and NT-proBNP. Methods Totally 86 hypertensive patients with diabetes mellitus who were diagnosed as having hyperlipidemia at Tangshan People’s Hospital Affiliated to Hebei United University were randomly divided into two groups. 42 cases in the observation group were treated with diet control plus atorvastatin 20 mg combined with ezetimibe 10 mg; control group 44 patients with diet control plus atorvastatin 40 mg, 12 weeks after treatment were compared between the two groups LDL- C, NT-proBNP and MMP-9, hsCRP plasma concentrations. Correlation of MMP-9 with hsCRP and NT-proBNP was analyzed using Pearson’s linear correlation. Results The levels of LDL-C, hsCRP and MMP-9 in the observation group decreased significantly (P <0.05), and NT-proBNP in the control group improved significantly compared with the observation group (P <0.05). There was a significant positive correlation between MMP-9 and hsCRP (r = 0.352, P = 0.001) and no correlation with NT-proBNP (r = -0.060, P = 0.584). Conclusions Atorvastatin combined with ezetimibe may reduce LDL-C and control inflammatory response more significantly than atorvastatin monotherapy. In atorvastatin combined with atorvastatin and ezetimibe, NT-proBNP The impact is more obvious. MMP-9 and hsCRP have a significant positive correlation, indicating that MMP-9 is an inflammatory cytokines, not an indicator of cardiac function.