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目的研究瑞舒伐他汀降脂、拉西地平达标降压对高血压病患者颈动脉粥样硬化颈动脉内膜中层厚度(CIMT)及颈动脉斑块的影响。方法筛选60例高血压病合并高脂血症颈动脉内膜中层厚度增厚和粥样硬化斑块的患者,随机分为治疗组(A组)和对照组(B组),给予阿司匹林(拜阿司匹林)0.1 g,1次/d,在此基础上,A组给予瑞舒伐他汀(托妥)10 mg,每晚1次,拉西地平(乐息平)4 mg,1次/d口服;B组给予普伐他汀(美百乐镇)20 mg,每晚1次,拉西地平4 mg,1次/d口服。血压不达标者拉西地平加至8 mg,1次/d,再加用氢氯噻嗪12.5～25.0 mg,1次/d。12个月后观察CIMT和粥样硬化斑块的变化。结果 A、B两组均可降低CIMT和消退颈动脉斑块,但A组较B组CIMT降低更明显(P<0.01),颈动脉斑块消退更明显(P<0.01),差异有统计学意义(P<0.01)。结论瑞舒伐他汀与拉西地平联合应用,可以发挥降压和抗动脉粥样硬化的协同作用。
Objective To investigate the effects of rosuvastatin on lipid lowering and lacidipine standard antihypertensive effect on carotid artery intima-media thickness (CIMT) and carotid artery plaque in patients with essential hypertension. Methods Sixty patients with hypertensive disease complicated with hyperlipidemia with thick carotid intima-media thickness and atherosclerotic plaque were randomly divided into treatment group (A group) and control group (B group), given aspirin Aspirin 0.1 g once a day, and on this basis, group A was given rosuvastatin 10 mg once daily, lacidipine 4 mg once daily ; Group B was given pravastatin (Mei Baile town) 20 mg once night, lacidipine 4 mg, 1 time / d orally. Ralidipine, which does not meet the blood pressure standard, was added to 8 mg once daily and hydrochlorothiazide 12.5 to 25.0 mg once daily. Changes of CIMT and atherosclerotic plaque were observed 12 months later. Results Both CIMT and carotid artery plaque were decreased in groups A and B, but the CIMT in group A was significantly lower than that in group B (P <0.01), and the regression of carotid plaques was more obvious (P <0.01) Significance (P <0.01). Conclusion Rosuvastatin combined with lacidipine can exert the synergistic effect of antihypertensive and atherosclerosis.