CAJ | 학술논문

目的：探讨氨氯地平联合阿托伐他汀对高血压合并血脂异常患者治疗改善程度，并分析对血管功能的影响。方法选择186例高血压合并血脂异常患者，应用随机数字表随机分为对照组（91例）和治疗组（95例），对照组给予氨氯地平治疗，治疗组在对照组基础上给予阿托伐他汀钙片治疗。主要观察指标为治疗前后收缩压和舒张压的差值，并采用高分辨彩色多普勒超声仪检测颈动脉内中膜厚度（ IMT）及颈动脉斑块面积，比较治疗前后差值。并测定血清总胆固醇（ TC）、三酰甘油（ TG）、低密度脂蛋白胆固醇（ LDL-C）及血液黏度、红细胞比容、红细胞聚集指数等指标，比较治疗前后改变程度。结果治疗组收缩压和舒张压治疗前后差值分别为（25．76±4．81）mmHg和（12．40±3．66）mmHg，均高于对照组（t＝9．48、8．76，均P＜0．05）；治疗组IMT和斑块面积治疗前后差值分别为（0．10±0．11）mm和（0．33±0．14）mm2，均多于对照组（t＝5．40、5．93，均P ＜0．05）。治疗组 TC、TG 和 LDL-C 治疗前后差值分别为（1．06±0．38） mmol/L、（0．76±0．31）mmol/L和（0．58±0．20）mmol/L，均高于对照组（t＝6．85、6．13、7．02，均P＜0．05）；治疗组血浆黏度、全血黏度、红细胞比容和红细胞聚积指数治疗前后差值分别为（0．36±0．08） Pa· s、（0．51±0．14） Pa· s、（0．41±0.12）和（0．31±0．12），均高于对照组（t＝5．81、4．97、5．11、6．86，均P＜0．05）。结论氨氯地平联合阿托伐他汀对高血压合并血脂异常能够显著降低患者的血压和血脂，改善血液流变学状态，对血管功能具有较好的保护作用。
목적：탐토안록지평연합아탁벌타정대고혈압합병혈지이상환자치료개선정도，병분석대혈관공능적영향。방법선택186례고혈압합병혈지이상환자，응용수궤수자표수궤분위대조조（91례）화치료조（95례），대조조급여안록지평치료，치료조재대조조기출상급여아탁벌타정개편치료。주요관찰지표위치료전후수축압화서장압적차치，병채용고분변채색다보륵초성의검측경동맥내중막후도（ IMT）급경동맥반괴면적，비교치료전후차치。병측정혈청총담고순（ TC）、삼선감유（ TG）、저밀도지단백담고순（ LDL-C）급혈액점도、홍세포비용、홍세포취집지수등지표，비교치료전후개변정도。결과치료조수축압화서장압치료전후차치분별위（25．76±4．81）mmHg화（12．40±3．66）mmHg，균고우대조조（t＝9．48、8．76，균P＜0．05）；치료조IMT화반괴면적치료전후차치분별위（0．10±0．11）mm화（0．33±0．14）mm2，균다우대조조（t＝5．40、5．93，균P ＜0．05）。치료조 TC、TG 화 LDL-C 치료전후차치분별위（1．06±0．38） mmol/L、（0．76±0．31）mmol/L화（0．58±0．20）mmol/L，균고우대조조（t＝6．85、6．13、7．02，균P＜0．05）；치료조혈장점도、전혈점도、홍세포비용화홍세포취적지수치료전후차치분별위（0．36±0．08） Pa· s、（0．51±0．14） Pa· s、（0．41±0.12）화（0．31±0．12），균고우대조조（t＝5．81、4．97、5．11、6．86，균P＜0．05）。결론안록지평연합아탁벌타정대고혈압합병혈지이상능구현저강저환자적혈압화혈지，개선혈액류변학상태，대혈관공능구유교호적보호작용。
Objective To explore the degree of the improvement for hypertension patients with dyslipidemia by amlodipine combination atorvastatin treatment, and analyze the influence on vascular function.Methods 186 hypertension patients with dyslipidemia were selected.According to random number table,they were divided into the control group (91 cases) and the treatment group (95 cases),the control group was given amlodipine treatment,the treatment group was given Atorvastatin Calcium Tablets on the basis of the control group.The main indexes were the difference of systolic and diastolic blood pressure before and after the treatment,and high resolution detection of carot-id artery intima media thickness ( IMT) and carotid plaque area by color Doppler ultrasoundand.Serum total choles-terol ( TC) ,triglyceride ( TG) ,low density lipoprotein cholesterol ( LDL-C) and blood viscosity,hematocrit,erythro-cyte aggregation index were compared the change degree before and after treatment.Results The differences of pre and post-treatment on the systolic and diastolic blood pressure of the treatment group were (25.76 ±4.81)mmHg and (12.40 ±3.66)mmHg,higher than those of the control group,the difference was statistically significant (t=9.48, 8.76,all P<0.05).The differences of pre and post-treatment on IMT and plaque area of the treatment group were (0.10 ±0.11) mm and (0.33 ±0.14) mm2,higher than those of the control group,there was statistical significant differences (t=5.40,5.93,all P<0.05).The differences of pre and post-treatment on TC,TG and LDL-C of the treatment group were(1.06 ±0.38)mmol/L,(0.76 ±0.31)mmol/L and (0.58 ±0.20)mmol/L,higher than those of the control group,the difference was statistically significant (t=6.85,6.13,7.02,all P<0.05).The differences of pre and post-treatment on plasma viscosity,whole blood viscosity,hematocrit and erythrocyte of the treatment group were (0.36 ±0.08)Pa· s,(0.51 ±0.14)Pa· s,(0.41 ±0.12) and (0.31 ±0.12),higher than those of the con-trol group,the difference was statistically significant (t=5.81,4.97,5.11,6.86,all P<0.05).Conclusion The combination of amlodipine and atorvastatin on hypertension patients with dyslipidemia could reduce blood pressure and blood fat significantly,improve blood rheology,which has a good protective effect on vascular function.