阿托伐他汀联合依折麦布对高血压合并糖尿病患者血清炎症因子及颈动脉斑块的影响

发布时间：2018-01-31 20:01

本文关键词： 阿托伐他汀依折麦布血脂血清炎症因子颈动脉粥样硬化斑块　出处：《昆明医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：[目的]探究阿托伐他汀与依折麦布联合治疗对高血压合并糖尿病患者血脂、血清中炎症因子及颈部动脉粥样硬化斑块的影响。[方法]选取2015年8月-2016年5月期间,在昆明医科大学附属甘美医院心内科门诊或住院部就诊,行颈动脉彩色多普勒超声检查提示有颈动脉粥样硬化斑块的高血压合并糖尿病患者100例为研究对象,通过抽签的方式随机将所有入选患者分为治疗组A组及对照组B组,两组均为50例研究对象。收集所有入选者的基本资料含概性别、年龄、体重指数(body mass index,BMI)、有无烟酒史,血液检测资料包括甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、空腹血糖(fasting blood glucose,FBG)、血浆糖化血红蛋白(hemoglobinAlC,HbA1C)以及高敏 C 反应蛋白(high-sensitive C-reactive protein,hs-CRP),其他资料还包含:患者血压(收缩压(systolic blood pressure,SBP),舒张压(diastolic blood pressure,DBP)),颈动脉内-中膜厚度(carotid intima-media thickness,CIMT),过程中严密监测患者的肝肾功能、药物不良反应及有无相关并发症。A组采用阿托伐他汀钙片20mg+依折麦布10mg联合治疗,B组采用单一阿托伐他汀钙片20mg,经过3个月治疗后观察对比两组患者之间患者血脂、血清炎症因子及颈动脉内-中膜厚度的变化情况;若差异无明显统计学意义则适当延长随访时间。[结果]3个月后,A、B两组患者的总胆固醇、甘油三醋、低密度脂蛋白胆固醇、高敏C反应蛋白均较治疗前下降,且A组下降幅度大于B组(P0.05),差异有统计学意义。两组高密度脂蛋白胆固醇含量较前升高(P0.05),差异不具有明显统计学意义。颈动脉内-中膜厚度较前稍减轻(P0.05),差异无统计学意义。后延长颈动脉内-中膜厚度随访时间,经10个月跟踪随访后,2组颈动脉内-中膜厚度较前明显减轻(P0.05),差异有明显统计学意义。[结论]高血压合并糖尿病患者使用阿托伐他汀联合依折麦布治疗可以更好的降低血脂、血清炎症因子水平,改善颈部动脉血管内-中膜厚度,最终减慢动脉粥样硬化的进展,甚至可以逆转斑块形成。
[Abstract]:[Objective] to investigate the effects of combined treatment of Atto vastatin and Ezeimebum on blood lipids, serum inflammatory factors and carotid atherosclerotic plaque in patients with hypertension and diabetes mellitus. [Methods: from August 2015 to May 2016, we visited the Department of Cardiology, Department of Cardiology, Ganmei Hospital affiliated to Kunming Medical University. Carotid color Doppler ultrasonography showed that 100 cases of hypertension complicated with diabetes mellitus with carotid atherosclerotic plaques were studied. By drawing lots, all the patients were randomly divided into treatment group A and control group B, both groups were 50 cases. Body mass index (mass), history of alcohol and tobacco, blood test data including triglyceride-triglyceride-triglyceride-triglyceride-triglyceride-triglyceride-triglyceride-triglyceride-triglyceride (TG-). Total cholesterol total cholesterol cholesterol. High density lipoprotein cholesterol (HDL-C). Low density lipoprotein cholesterol (LDL-C). Fasting blood glucose (FBG) and plasma glycosylated hemoglobin (AlC). HbA1C) and Gao Min C-reactive protein high-sensitive hs-CRP). Other data included: systolic blood pressure (SBP). Diastolic blood pressure (DBP). Carotid intima-media thickness (IMT) and carotid intima-media thicknessen (CIMT) were closely monitored during the course of liver and kidney function. Adverse drug reactions and related complications. Group A was treated with 20 mg Ezeimebumin 10 mg Atto vastatin calcium tablets. Group B was treated with single Atto vastatin calcium tablet 20 mg. After 3 months of treatment, the changes of serum lipids, serum inflammatory factors and carotid intima-media thickness were observed and compared between the two groups. If the difference was not statistically significant, the follow-up time should be prolonged. [Results after 3 months, the total cholesterol, triglyceride, low density lipoprotein cholesterol and Gao Min C-reactive protein in group A were lower than those before treatment, and the decrease in group A was greater than that in group B (P 0.05). The difference was statistically significant. The content of HDL-C in the two groups was significantly higher than that in the anterior group (P 0.05), but the difference was not statistically significant. The intima-media thickness of carotid artery was slightly lighter than that of the anterior group (P 0.05). There was no significant difference between the two groups. After 10 months follow-up, the carotid intima-media thickness of the two groups was significantly reduced than that of the former group (P 0.05). The difference was statistically significant. [Conclusion: Atto vastatin combined with Ezeimebumin can reduce blood lipids, serum inflammatory factors and improve the intima-media thickness of carotid artery in patients with hypertension and diabetes mellitus. Eventually slowing down the progression of atherosclerosis can even reverse plaque formation.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R544.1;R587.1

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