银杏酮酯滴丸联合阿托伐他汀对高血压伴颈动脉硬化患者血管内皮功能、血清网膜素-1 和 H cy 的影响

摘要

目的:观察银杏酮酯滴丸联合阿托伐他汀对高血压伴动脉硬化患者血管内皮功能、血清网膜素-1和同型半胱氨酸(Hcy)的影响.方法:选择我院收治的高血压伴颈动脉硬化患者120例为研究对象,随机分为阿托伐他汀组和联合治疗组(阿托伐他汀联合银杏酮酯滴丸治疗) ,各60例,两组均在健康教育、饮食、运动等干预基础上给予不同药物.治疗12周后,比较两组治疗前后血压,血脂、颈动脉内膜中层厚度(IMT ) 、斑块面积、内皮素-1 (ET-1) 、一氧化氮(NO) 、血清网膜素-1 、 Hcy水平.结果:与治疗前比较,治疗后两组血压、血脂(除 HDL-C显著升高外) 、血清ET-1 、 Hcy水平均显著降低, IMT 、斑块面积显著减小,血清 NO 、网膜素-1水平显著升高( P均＜0-01) ;且与阿托伐他汀组比较,联合治疗组血压、血脂(除HDL-C显著升高外) 、血清ET-1 [(136-42 ± 15-57) μg／ml比(116-57 ± 13-28) μg／ml] 、 Hcy [ (15-46 ± 3-25) μmol／L比(10-58 ± 3-11) μmol／L]水平均显著降低, IMT [ (1-43 ± 0-21) mm比(1-26 ± 0-19) mm] 、斑块面积[ (22-53 ± 1-28) mm2比(20-67 ± 1-14) mm2 ]显著减小,血清NO [ (102-43 ± 12-37 ) μmol／L比(129-84 ± 13-36 ) μmol／L ] 、网膜素-1 [ (176-57 ± 45-20) μg／ml比(198-73 ± 45-38) μg／ml]水平显著升高(P＜0-05或＜0-01) .结论:高血压伴颈动脉硬化患者采用银杏酮酯滴丸并阿托伐他汀治疗,可显著降压、降血脂,改善血管内皮功能及动脉硬化程度.%Objective :To observe influence of Ginkgo ketone ester dropping pills (GKE) combined atorvastatin on vascular endothelial function ,serum levels of omentin-1 and homocysteine (Hcy) in hypertensive patients with ca-rotid arteriosclerosis (CAS).Methods : A total of 120 hypertensive patients with CAS treated in our hospital were selected ,randomly and equally divided into atorvastatin group and combined treatment group (received GKE com-bined atorvastatin ) ,both groups received corresponding therapy based on health education ,diet and exercise etc for 12 weeks.Blood pressure ,blood lipids ,carotid intima-media thickness (IMT ) ,plaque size ,levels of endothelin (ET)-1 ,nitric oxide (NO) ,serum omentin-1 and Hcy were compared between two groups before and after treat- ment .Results : Compared with before treatment ,there were significant reductions in blood pressure ,blood lipids (except significant rise in HDL-C) ,serum levels of ET-1 and Hcy ,IMT and plaque size ,and significant rise in ser-um levels of NO and omentin-1 in two groups after treatment , P＜0-01 all.Compared with atorvastatin group after treatment ,there were significant reductions in blood pressure ,blood lipids (except significant rise in HDL-C) ,ser-um levels of ET-1 [ (136-42 ± 15-57) μg／ml vs.(116-57 ± 13-28) μg／ml] and Hcy [ (15-46 ± 3-25 ) μmol／L vs. (10-58 ± 3-11) μmol／L] ,IMT [ (1-43 ± 0-21) mm vs.(1-26 ± 0-19) mm] and plaque size [ (22-53 ± 1-28) mm2 vs.(20-67 ± 1-14 ) mm2 ] ,and significant rise in serum levels of NO [ (102-43 ± 12-37) μmol／L vs.(129-84 ± 13-36) μmol／L] and omentin-1 [ (176-57 ± 45-20 ) μg／ml vs.(198-73 ± 45-38) μg／ml] in combined treatment group , P＜0-05 or ＜0-01- Conclusion : Ginkgo ketone ester dropping pills combined atorvastatin can significantly improve vascular endothelial function and arteriosclerosis while reducing blood pressure and blood lipids in hyperten-sive patients with carotid arteriosclerosis .