左旋氨氯地平联合他汀类药物治疗老年收缩期高血压临床观察.docVIP

左旋氨氯地平联合他汀类药物治疗老年收缩期高血压临床观察 　【摘要】 目的 探讨第三代二氢吡啶类钙离子拮抗剂与他汀类药物联合治疗对老年收缩期高血压病患者收缩压、脉压以及相关因素的影响。方法 采用随机单盲平行对照的方法分析92例老年收缩期高血压病患者的临床资料，并进行统计学分析。结果 92例中，左旋氨氯地平+辛伐他汀治疗45例（治疗组），左旋氨氯地平治疗47例（对照组），两组治疗共18个月。两组降低收缩压和缩小脉压效果：治疗组总有效率为93.3%；对照组总有效率为80.9%。两组间总有效率比较，经Ridit检验，治疗组与对照组分别为，R=0.36和R=0.62，差异有显著性（P＜005）；治疗组总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）以及颈动脉内-中膜厚度（IMT）均有降低，动脉粥样硬化斑块明显改善，与对照组比较差异有显著性（P＜005）。结论 左旋氨氯地平联合辛伐他汀能明显降低老年收缩期高血压病患者的收缩压，缩小脉压且能逆转动脉粥样硬化斑块，TC、TG、LDL、HDL以及IMT的改善亦明显 【关键词】 收缩期高血压 老年 左旋氨氯地平 他汀类 辛伐他汀 Clinical observation on combination with levoamlodipine and statins for elderly systolic hypertension ［Abstract］ Objective To observe the curative effect of combined levoamlodipine and statins for systolic hypertensive patients in the elderly.Methods 92 cases of systolic hypertensive patients in the elderly were randomly divided into the combination of levoamlodipine and simvastatin （treatment group，n=45） and levoamlodipine（control group，n=47）.Levoamlodipine 2.5 mg~5 mg and simvastatin 10 mg were administered once a day for 18 months.The values of systolic blood pressure，pulse pressure，TC，TG，LDL，HDL and carotid artery thickness were compared before and after administration.Results The total efficiency after 18 months was as follows: the treatment group was 93.3% and the control group 80.9%.There was a difference between two groups（P＜005）.TC，TG，LDL in both groups decreased to normal，and the pulse pressure and carotid artery thickness in the treatment group decreased significantly（P＜001），compared with that before treatment.Conclusion It is effective and safe to treat systolic blood pressure，pulse pressure and carotid artery thickness for systolic hypertensive patients in the elderly with the combination of levoamlodipine and simvastatin. ［Key words］ systolic hypertension；aged；levoamlodipine；statins；simvastatin 高血压是老年人致残和死亡的主要危险因素，老年高血压不仅患病率高、危害性大而且血压控制率低。越来越多的证据表明，老年高血压常表现为较高的收缩压（SBP），较低的舒张压（DBP）和脉压（PP）增宽。而后者反映了大动脉粥样硬化性僵度增加和动脉弹性降低，是心血管病重要的独立危险因素。本文旨在探讨第三代二氢吡啶类钙离子拮抗剂联用他汀类药物对老年收