瑞舒伐他汀钙联合氨氯地平治疗高血压合并冠心病的疗效及对患者血管内皮功能的影响
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摘要
目的探讨瑞舒伐他汀钙联合氨氯地平治疗高血压合并冠心病(CHD)的疗效及对患者血管内皮功能的影响。方法选取2017年1月至2018年1月期间在内科住院治疗的高血压合并CHD患者200例,采用随机数字表将患者分为两组,各100例。对照组采用氨氯地平阿托伐他汀钙片治疗,研究组采用瑞舒伐他汀钙联合氨氯地平治疗。采用放射性免疫法与硝酸盐还原酶法分别检测血清内皮素-1(ET-1)与一氧化氮(NO)水平,比较两组临床疗效与血管内皮功能的差异。结果研究组治疗总有效率明显高于对照组(P<0.05)。治疗前,两组SBP、DBP、TC、TG、LDL-C、HDL-C水平比较差异无统计学意义(P>0.05),治疗后,两组SBP、DBP、TC、TG、LDL-C水平明显低于治疗前,HDL-C水平明显高于治疗前,差异有统计学意义(P<0.001),且研究组上述指标均明显优于对照组(P<0.001)。治疗前,两组血清ET-1、NO水平比较差异无统计学意义(P>0.05),治疗后,两组ET-1水平明显低于治疗前,NO水平明显高于治疗前,差异有统计学意义(P<0.001),且研究组ET-1、NO水平均明显优于对照组(P<0.001)。两组药物不良反应发生率比较差异无统计学意义(P>0.05)。结论瑞舒伐他汀钙联合氨氯地平治疗高血压合并CHD患者的疗效满意,可有效控制血压及血脂水平,从而改善血管内皮功能,值得临床推广应用。
Objective To investigate the effect of rosuvastatin calcium combined with amlodipine in the treatment of hypertension complicated with coronary heart disease(CHD) and its effect on the vascular endothelial function of patients.Methods 200 cases of hypertension with CHD admitted in internal medicine ward of our hospital during the period of January 2017 and January 2018 were selected,and the patients were divided into two groups by random number table,with 100 cases in each group.Control group were given amlodipine atorvastatin calcium tablets,and study group were given rosuvastatin calcium combined amlodipine.Serum levels of endothelin-1(ET-1) and nitric oxide(NO) were respectively detected by radioimmunoassay and nitrate reductase assay,and then the difference of clinical curative effect and vascular endothelial function between two groups were compared.Results The total effective rate of the study group was significantly higher than that of the control group(P<0.05).Before treatment,difference of the levels of SBP, DBP,TC,TG,LDL-C and HDL-C in the two groups was not statistically significant(P>0.05).After treatment,the levels of SBP,DBP,TC,TG and LDL-C in the two groups were significantly lower than those before treatment,and the levels of HDL-C were significantly higher than those before treatment,difference was statistically significant(P<0.001),and the above-mentioned indexes in the study group were obviously better than those in the control group(P<0.001).Before treatment,difference of the serum levels of ET-1 and NO in the two groups was not statistically significant(P>0.05).After treatment,the levels of ET-1 in the two groups were significantly lower than those before treatment,and the levels of NO were significantly higher than those before treatment(P<0.001),and both serum levels of ET-1 and NO in the study group were obviously better than those in the control group(P<0.001).There was no statistically significant difference in the incidence of adverse drug reactions between the two groups(P>0.05).Conclusion Rosuvastatin calcium combined with amlodipine in the treatment of hypertensive patients with CHD is satisfactory,it can effectively control blood pressure and blood lipid levels,so as to improve vascular endothelial function,which is worthy of clinical popularization and application.
Objective To investigate the effect of rosuvastatin calcium combined with amlodipine in the treatment of hypertension complicated with coronary heart disease(CHD) and its effect on the vascular endothelial function of patients.Methods 200 cases of hypertension with CHD admitted in internal medicine ward of our hospital during the period of January 2017 and January 2018 were selected,and the patients were divided into two groups by random number table,with 100 cases in each group.Control group were given amlodipine atorvastatin calcium tablets,and study group were given rosuvastatin calcium combined amlodipine.Serum levels of endothelin-1(ET-1) and nitric oxide(NO) were respectively detected by radioimmunoassay and nitrate reductase assay,and then the difference of clinical curative effect and vascular endothelial function between two groups were compared.Results The total effective rate of the study group was significantly higher than that of the control group(P<0.05).Before treatment,difference of the levels of SBP, DBP,TC,TG,LDL-C and HDL-C in the two groups was not statistically significant(P>0.05).After treatment,the levels of SBP,DBP,TC,TG and LDL-C in the two groups were significantly lower than those before treatment,and the levels of HDL-C were significantly higher than those before treatment,difference was statistically significant(P<0.001),and the above-mentioned indexes in the study group were obviously better than those in the control group(P<0.001).Before treatment,difference of the serum levels of ET-1 and NO in the two groups was not statistically significant(P>0.05).After treatment,the levels of ET-1 in the two groups were significantly lower than those before treatment,and the levels of NO were significantly higher than those before treatment(P<0.001),and both serum levels of ET-1 and NO in the study group were obviously better than those in the control group(P<0.001).There was no statistically significant difference in the incidence of adverse drug reactions between the two groups(P>0.05).Conclusion Rosuvastatin calcium combined with amlodipine in the treatment of hypertensive patients with CHD is satisfactory,it can effectively control blood pressure and blood lipid levels,so as to improve vascular endothelial function,which is worthy of clinical popularization and application.
引文
[1] 孙东升.高血压冠心病合并颈动脉粥样硬化临床应用氨氯地平阿托伐他汀钙片治疗的疗效 [J].中国实用医药,2017,12(10):29-32.
[2] 黄毅,崔跃,刘富湘,等.氨氯地平联合盐酸贝那普利对高血压伴冠心病患者的疗效 [J].慢性病学杂志,2017,18(3):256-258.
[3] 艾建华.氨氯地平阿托伐他汀钙片治疗高血压合并冠心病的临床效果[J].中国当代医药,2016,23(36):114-116.
[4] 赵伟平.苯磺酸氨氯地平联合瑞舒伐他汀钙片治疗高血压病合并冠心病和颈动脉粥样硬化患者的效果观察[J].临床合理用药杂志,2018,11(5):1-2.
[5] Alzoughool M,Alahmari H,Khan A.Patterns of Physical Activity and the Risk of Coronary Heart Disease:A Pilot Study[J].Int J Environ Res Public Health,2018,15(4):pii:E778.
[6] Burkett MS,Macci BA,Cline TW,et al.An Assessment of an Outpatient Antimicrobial Therapy Program in a Rural Medical Center:A Retrospective Chart Review[J].Crit Care Nurs Q,2018,41(2):109-120.
[7] Yim J,Rabkin SW.A patient-specific approach to assessing blood pressure management in patients with hypertension and coronary artery disease[J].J Clin Hypertens,2018,20(2):233-239.
[8] 刘毅.瑞舒伐他汀联合氨氯地平治疗老年高血压合并冠心病的临床观察[J].中西医结合心血管病电子杂志,2015,3(6):111-112.
[9] 李丹,文倩.氨氯地平阿托伐他汀钙片治疗高血压病合并冠心病的疗效观察[J].中国医院用药评价与分析,2018,18(5):610-612.
[10] 肖亚康.八式太极拳运动对原发性高血压患者血压水平、血管内皮功能及生活质量的影响[J].中国老年学杂志,2018,38(10):2403-2405.
[11] Lee YH,Viji M,Lee E,et al.Synthesis and characterization of Rosuvastatin calcium impurity A;a HMG-CoA reductase inhibitor[J].Tetrahedron Lett,2017,58(26):2614-2617.
[12] Dudhipala N,Veerabrahma K.Improved anti-hyperlipidemic activity of Rosuvastatin Calcium via lipid nanoparticles:Pharmacokinetic and pharmacodynamic evaluation[J].Eur J Pharm & Biopharm,2017,110:47-57.
[13] 鲜廉杰.氨氯地平联合瑞舒伐他汀治疗冠心病合并高血压的疗效及安全性分析[J].齐齐哈尔医学院学报,2017,38(18):2146-2147.
[14] 朱蕾,林泽鹏,舒平春,等.瑞舒伐他汀对高血压并低密度脂蛋白胆固醇轻度升高患者的疗效[J].广东医学,2016,37(10):1558-1560.
[15] Elliott WJ,Bistrika EA.Perindopril Arginine and Amlodipine Besylate for Hypertension:A Safety Evaluation[J].Expert Opin Drug Saf,2018,17(2):207-216.
[16] 秦汉,胡志希,李琳,等.雪莲通脉丸对冠心病气虚血瘀证小鼠血管内皮细胞功能相关指标ET-1、NO、ACE的影响[J].湖南中医药大学学报,2016,36(2):25-28.
[2] 黄毅,崔跃,刘富湘,等.氨氯地平联合盐酸贝那普利对高血压伴冠心病患者的疗效 [J].慢性病学杂志,2017,18(3):256-258.
[3] 艾建华.氨氯地平阿托伐他汀钙片治疗高血压合并冠心病的临床效果[J].中国当代医药,2016,23(36):114-116.
[4] 赵伟平.苯磺酸氨氯地平联合瑞舒伐他汀钙片治疗高血压病合并冠心病和颈动脉粥样硬化患者的效果观察[J].临床合理用药杂志,2018,11(5):1-2.
[5] Alzoughool M,Alahmari H,Khan A.Patterns of Physical Activity and the Risk of Coronary Heart Disease:A Pilot Study[J].Int J Environ Res Public Health,2018,15(4):pii:E778.
[6] Burkett MS,Macci BA,Cline TW,et al.An Assessment of an Outpatient Antimicrobial Therapy Program in a Rural Medical Center:A Retrospective Chart Review[J].Crit Care Nurs Q,2018,41(2):109-120.
[7] Yim J,Rabkin SW.A patient-specific approach to assessing blood pressure management in patients with hypertension and coronary artery disease[J].J Clin Hypertens,2018,20(2):233-239.
[8] 刘毅.瑞舒伐他汀联合氨氯地平治疗老年高血压合并冠心病的临床观察[J].中西医结合心血管病电子杂志,2015,3(6):111-112.
[9] 李丹,文倩.氨氯地平阿托伐他汀钙片治疗高血压病合并冠心病的疗效观察[J].中国医院用药评价与分析,2018,18(5):610-612.
[10] 肖亚康.八式太极拳运动对原发性高血压患者血压水平、血管内皮功能及生活质量的影响[J].中国老年学杂志,2018,38(10):2403-2405.
[11] Lee YH,Viji M,Lee E,et al.Synthesis and characterization of Rosuvastatin calcium impurity A;a HMG-CoA reductase inhibitor[J].Tetrahedron Lett,2017,58(26):2614-2617.
[12] Dudhipala N,Veerabrahma K.Improved anti-hyperlipidemic activity of Rosuvastatin Calcium via lipid nanoparticles:Pharmacokinetic and pharmacodynamic evaluation[J].Eur J Pharm & Biopharm,2017,110:47-57.
[13] 鲜廉杰.氨氯地平联合瑞舒伐他汀治疗冠心病合并高血压的疗效及安全性分析[J].齐齐哈尔医学院学报,2017,38(18):2146-2147.
[14] 朱蕾,林泽鹏,舒平春,等.瑞舒伐他汀对高血压并低密度脂蛋白胆固醇轻度升高患者的疗效[J].广东医学,2016,37(10):1558-1560.
[15] Elliott WJ,Bistrika EA.Perindopril Arginine and Amlodipine Besylate for Hypertension:A Safety Evaluation[J].Expert Opin Drug Saf,2018,17(2):207-216.
[16] 秦汉,胡志希,李琳,等.雪莲通脉丸对冠心病气虚血瘀证小鼠血管内皮细胞功能相关指标ET-1、NO、ACE的影响[J].湖南中医药大学学报,2016,36(2):25-28.