阿托伐他汀钙对高血压病患者血脂异常的疗效及对高敏C反应蛋白的影响

摘要

Objective To investigate the effect and safety of atovastatin calcium on dyslipidemia and hypersensitive C-reactive protein in hypertension patients. Methods One hundred and twenty-eight hypertensive patients with dyslipidedmia were divided into two groups: control group and treatment group. All patients were in low-fat and low-cholesterol diet and received antihypertensive treatment as usual. Patients in treatment group took atovastatin (20 mg/day) for 12 weeks. Systolic blood pressure (SBP), diastolic blood pressure(DBP), serum total glycerin (TG), total cholesterol ( TC ), low-dense-lipoprotein cholesterol ( LDL-C ), high-dense-lipoprotein cholesterol (HDL-C), very low-dense-lipoprotein cholesterol (VLDL-C), hypersensitive C-reactive protein (hs-CRP), creatinin (Cr), glutamate pyruvate transaminase (ALT) and creatine kinase (CK) were measured before and after the treatment. Results In patients with atovastatin treatment, TG was reduced 16%[(1.6 ±1.2)mmoL/L vs (2.0 ±0.9) mmol/L, P ＜ 0.05], TC was reduced 24% [(4 ± 1 ) mmol/L vs (6 ± 1 ) mmoL/L, P ＜ 0.01], LDL-C was reduced 34% [(3 ± 1 ) mmol/L vs (4 ± 1 ) mmol/L, P ＜ 0.01] and hs-CRP was significantly reduced [(2.3 ± 1.5 )mg/L vs (5.3 ± 2.9)mg/L, P ＜ 0.01]. CK increased lightly in two patients with atovastatin treatment and were in normal range in one month although the patients received atovastatin ( 10 mg/day) treatment. Compared to control group, TC, LDL-C, VLDL-C and hs-CRP were significantly reduced in treatment group. There was no significant difference in HDL-C, SBP, DBP, Cr and ALT. Conclusion Atovastatin can decrease hypersensitive C-reactive protein in hypertension patients with dyslipidemia.%目的 观察阿托伐他汀钙对高血压病患者血脂异常的疗效和安全性及对高敏C反应蛋白(hs-CRP)的影响.方法 观察128例高血压伴有血脂异常的患者,其中治疗组68例,在降压治疗和低脂饮食的基础上,给予阿托伐他汀钙20 mg/d,睡前服,治疗12周;对照组60例,予降压治疗和低脂饮食.测定2组治疗前后的血压、TG、TC、LDL-C、HDL-C、极低密度脂蛋白胆固醇(VLDL-C)、hs-CRP、Cr、ALT、肌酸激酶水平,并进行比较分析.结果 治疗组用药后与用药前比较,血压无明显改变,TG下降[(1.6±1.2)mmol/L比(2.0±0.9)mmoL/L,P＜0.05],HDL-C有升高的趋势,但差异无统计学意义,TC下降[(4±1)mmol/L比(6±1)mmol/L,P＜0.01),LDL-C下降[(3±1)mmol/L比(4±1)mmol/L,P＜0.01],hs-CRP明显下降[(2.3±1.5)mg/L比(5.3±2.9)mg/L,P＜0.01].仅2例患者出现血清肌酸激酶的轻度升高,1个月后复查均恢复正常.与对照组治疗后比较,治疗组的TC、LDL-C、TG、VLDL-C和hs-CRP明显降低,差异有统计学意义(P＜0.05或P＜0.01),SBP、DBP、Cr及ALT均差异无统计学意义.结论 阿托伐他汀钙可有效地改善高血压病患者血脂异常和炎症状态,而且是安全的.