CAJ | 학술논문

目的：探讨硝苯地平控释片联合阿托伐他汀治疗高血压合并冠心病的疗效及对超敏C反应蛋白（h s‐CRP）及血管内皮功能的影响。方法将96例高血压合并冠心病患者随机分为单独硝苯地平控释片治疗组（常规组）和硝苯地平控释片联合阿托伐他汀治疗组（联合组），每组各48例。观察两组患者的降压疗效，心绞痛发作次数及心电图改变及其对血管内皮素‐1、一氧化氮和hs‐CRP水平的影响。结果治疗后，联合组患者的降压、心绞痛和心电图改善的总体有效率均明显高于常规组（P＜0．05）；常规组治疗前后总胆固醇水平差异无统计学意义（P＞0．05），而联合组治疗后总胆固醇水平则呈现下降趋势（P＜0．05），其余各项血脂指标两组均未出现明显改变（P＞0．05）；两组患者hs‐CRP、血管内皮素‐1和一氧化氮水平均出现不同程度的改变，且联合组的改善程度明显优于常规组（P＜0．05）。此外，两组患者均未出现明显不良反应。结论硝苯地平控释片联合阿托伐他汀对高血压合并冠心病患者具有良好临床疗效，其作用机制可能是通过调控hs‐CRP和改善血管内皮功能而起作用。
목적：탐토초분지평공석편연합아탁벌타정치료고혈압합병관심병적료효급대초민C반응단백（h s‐CRP）급혈관내피공능적영향。방법장96례고혈압합병관심병환자수궤분위단독초분지평공석편치료조（상규조）화초분지평공석편연합아탁벌타정치료조（연합조），매조각48례。관찰량조환자적강압료효，심교통발작차수급심전도개변급기대혈관내피소‐1、일양화담화hs‐CRP수평적영향。결과치료후，연합조환자적강압、심교통화심전도개선적총체유효솔균명현고우상규조（P＜0．05）；상규조치료전후총담고순수평차이무통계학의의（P＞0．05），이연합조치료후총담고순수평칙정현하강추세（P＜0．05），기여각항혈지지표량조균미출현명현개변（P＞0．05）；량조환자hs‐CRP、혈관내피소‐1화일양화담수평균출현불동정도적개변，차연합조적개선정도명현우우상규조（P＜0．05）。차외，량조환자균미출현명현불량반응。결론초분지평공석편연합아탁벌타정대고혈압합병관심병환자구유량호림상료효，기작용궤제가능시통과조공hs‐CRP화개선혈관내피공능이기작용。
Objective To explore the effect of Nifedipine Controlled Release Tablet combined with atorvastatin in the treatment of hypertension complicating coronary heart disease (CHD) and its influence on high sensitive C reac‐tive protein(hs‐CRP) and the vascular endothelial function .Methods 96 cases of hypertension complicating CHD were randomly divided into the single Nifedipine Controlled Release Tablet treatment group (routine group) and Nife‐dipine Controlled Release Tablet combined with atorvastatin treatment group (combined group ) ,48 cases in each group .The antihypertensive effects ,angina pectoris attack times ,ECG change ,influence on endothelin‐1 ,NO level and hs‐CRP were observed in the two groups .Results The overall effective rate in reducing blood pressure and the im‐provement of angina and ECG after treatment in the combined group were significantly higher than those in the rou‐tine group(P<0 .05);the total cholesterol level had no statistically significant difference between before and after treatment in the routine group ,but which in the combined group showed the decreasing trend(P<0 .05) ,the other lipid indexes had no obvious change in the two groups (P> 0 .05);hs‐CRP ,endothelin‐1 and NO levels in the two groups appeared the different degrees of change ,moreover the improvement degrees in the combined group was sig‐nificantly superior to those in the routine group(P<0 .05) .In addition ,no obvious adverse reactions occurred in the two groups .Conclusion Nifedipine Controlled Release Tablet combined with atorvastatin has good clinical effect in treating hypertension complicating CHD ,its mechanism may be through regulation of hs‐CRP and the improvement of the vascular endothelial function .