钙离子拮抗剂联合他汀类对高血压老年患者的疗效

摘要

目的:探讨钙离子拮抗剂联合他汀类药物对老年高血压患者的疗效,及对炎性因子水平的影响.方法:选择2014年10月至2015年10月我院收治的高血压老年患者124例作为研究对象,按随机数字表法均分为氨氯地平组(62例,在常规治疗基础上接受氨氯地平治疗)和联合治疗组(62例,在氨氯地平组基础上接受阿托伐他汀钙治疗).测量比较两组治疗前后血压、C反应蛋白(CRP)、白介素(IL)-6、内皮素(ET)及血脂水平,并比较两组的临床疗效及不良反应发生情况.结果:与氨氯地平组比较,联合治疗组治疗后收缩压[(143.57±3.14) mmHg比(131.73±3.42) mmHg]、舒张压[(82.17±3.26) mmHg比(76.51±3.27) mmHg]、CRP[(7.32±0.71) mg/L比(5.57±0.76) mg/L]、IL-6[(133.42±27.31) ng/L比(123.73±22.81) ng/L]、ET[(50.74±4.96) pg/L比(45.71±5.78) pg/L]、总胆固醇[(5.32±0.66) mmol/L比(4.12±0.52) mmol/L]、甘油三酯[(1.56±0.42) mmol/L比(1.21±0.37) mmol/L]、低密度脂蛋白-胆固醇水平[(3.12±0.48) mmol/L比(2.43±0.43) mmol/L]均显著降低,高密度脂蛋白-胆固醇水平[(1.41±0.12) mmol/L比(1.55±0.17) mmol/L]显著升高,P<0.05或<0.01.与氨氯地平组比较,联合治疗组治疗总有效率(77.4%比91.9%)显著升高,P=0.025.两组的不良反应无显著差异(P>0.05).结论:钙离子拮抗剂联合他汀类药物治疗老年高血压患者,能有效降低血压、血脂水平,减轻炎性反应,改善血管内皮细胞功能,值得临床推广.%Objective: To explore therapeutic effects of calcium channel blocker combined statins on aged patients with hypertension, and their influence on inflammatory factor levels.Methods: A total of 124 aged patients with hypertension, who were treated in our hospital from Oct 2014 to Oct 2015 , were randomly and equally divided into amlodipine group (received amlodipine therapy based on routine treatment) and combined treatment group (received atorvastatin calcium based on amlodipine group) according to random number table.Levels of blood pressure, C reactive protein (CRP), interleukin (IL)-6, endothelin (ET) and blood lipids before and after treatment, and therapeutic effect and incidence of adverse reactions were compared between two groups.Results: Compared with amlodipine group after treatment, there were significant reductions in levels of systolic blood pressure [(143.57±3.14) mmHg vs.(131.73±3.42) mmHg], diastolic blood pressure [(82.17±3.26) mmHg vs.(76.51±3.27) mmHg], CRP [(7.32±0.71) mg/L vs.(5.57±0.76) mg/L], IL-6 [(133.42±27.31) ng/L vs.(123.73±22.81) ng/L], ET [(50.74±4.96) pg/L vs.(45.71±5.78) pg/L], total cholesterol [(5.32±0.66) mmol/L vs.(4.12±0.52) mmol/L], triglyceride [(1.56±0.42)mmol/L vs.(1.21±0.37) mmol/L] and low density lipoprotein cholesterol [(3.12±0.48) mmol/L vs.(2.43±0.43) mmol/L], and significant rise in high density lipoprotein cholesterol level [(1.41±0.12) mmol/L vs.(1.55±0.17) mmol/L] in combined treatment group, P<0.05 or <0.01.Compared with amlodipine group, there was significant rise in total effective rate (77.4% vs.91.9%) in combined treatment group, P=0.025.There was no significant difference in incidence rate of adverse reactions between two groups (P>0.05).Conclusion: Calcium channel blocker combined statins possesses definite therapeutic effects on aged patients with hypertension.It can reduce levels of blood pressure and blood lipids and inflammations and improve vascular endothelial cell function, which is worth extending.