阿托伐他汀钙联合硝苯地平缓释片治疗轻中度高血压合并心脏病的疗效与肝肾功能影响

刘左玲　刘衍宇　凌云等

[摘要] 目的 阿托伐他汀钙联合硝笨地平缓释片治疗轻中度高血压合并心脏病的临床疗效及其对肝肾功能的影响。 方法 随机将150例轻中度高血压合并左室肥厚患者分为两组，对照组给予硝苯地平缓释片治疗，治疗组在此基础上加用阿托伐他汀钙治疗。治疗18个月后，比较两组血压、左室后壁厚度（LVPW）和室间隔厚度（IVS）及肝肾功能。 结果 两组治疗后血压均达标，治疗组收缩压、舒张压下降较对照组明显。两组LVPW和IVS均有所改善，治疗组改善更加明显。治疗组有2例患者出现转氨酶升高而停用阿托伐他汀钙，对照组无1例发生肝肾功能损害。 结论 阿托伐他汀钙联合硝苯地平缓释片联合治疗轻中度高血压合并左室肥厚患者疗效更优，且无明显肝肾损害。

[关键词] 轻中度高血压；左室肥厚；阿托伐他汀钙；硝笨地平缓释片

[中图分类号] R544.1；R589.2 [文献标识码] B [文章编号] 2095-0616（2015）11-66-03

[Abstract] Objective To ivvestigate the clinical effect of Atorvastatin calcium combined with Extended Release Nifedipine Tablets in the treatment of mild to moderate hypertension complicated with heart disease its effect on liver and renal function. Methods 150 patients with mild to moderate hypertension and left ventricular hypertrophy were divided into two groups，the control group was given Extended Release Nifedipine Tablets，the treatment was given atorvastatin calcium in addition to Extended Release Nifedipine Tablets.After 18 months of treatment，The blood pressure，left ventricular posterior wall thickness（LVPW），ventricular septal thickness（IVS）and the function of liver and kidney were compared between the two groups. Results The blood pressure of the 2 groups after treatment were standard.The systolic pressure，diastolic pressure decreased more significantly in the observation group than the control group.The LVPW and IVS were improved more obviously in the observation group.2 patients in the observation group appeared elevated transaminase and then reduced after the discontinuation of atorvastatin calcium.1 case in the control group appeared liver and kidney function damage. Conclusion Atorvastatin calcium combined with extended release nifedipine tablets has good effect in the treatment of mild to moderate hypertension with left ventricular hypertrophy，and has no obvious damage of liver and kidney.

[Key words] Mild to moderate hypertension；Left ventricular hypertrophy；Atorvastatin calcium；Nitric stupid nimodipine sustained-release tablets

原发性高血压是一种遗传与环境因素共同作用的遗传异质性疾病，主要表现为基因表达异常和病理性的血压升高。是中老年患者最常见的心血管疾病，也是心脑血管疾病的主要危险因素之一[1]。高血压总患病率约为30%～45%，且随年龄增长而急剧增加[2]。左室肥厚是高血压患者后期心血管病死亡和致残的独立危险因素，逆转左室肥厚能后显著改善高血压患者的临床结局及预后[3]。近年来探讨逆转高血压患者左室肥厚的药物是高血压治疗领域的活跃分子。本研究顺应目前研究热点，探讨轻中度高血压合并左室肥厚患者应用阿托伐他汀钙联合硝笨地平缓释片的降压效果及对患者左室舒张末期内径的影响，并且统计其对肝肾功能的影响，为临床治疗高血压合并左室肥厚患者提供参考。

1 资料与方法

1.1 一般资料

随机选择我院2012年1月～2013年6月就诊的老年轻中度高血压合并左室肥厚患者150例为研究对象，高血压及左室肥厚诊断标准符合2010年《中国高血压治疗指南》诊断标准，血压标准为收缩压140～179mm Hg或（和）舒张压90～109mm Hg。排除继发性高血压、血脂异常、肝肾功能不全、冠心病、脑血管病等疾病。将150例研究对象随机分为两组，对照组75例，平均年龄（65.3±3.6）岁，男39例，女36例。治疗组75例，平均年龄（64.9±4.1）岁，男38例，女37例。两组患者在年龄、性别构成、体重指数、血压（SBP、DBP、PP）、基础血脂（LDL-C）、左室舒张末内径（LVEDd）、肝功能（ALT、AST）、肾功能（肌酐）等方面比较无统计学意义（P>0.05），具有可比性。见表1。endprint