硝苯地平控释片与阿托伐他汀对高血压患者颈动脉内膜中层厚度及血管内皮功能的影响

目的比较观察单用硝苯地平控释片、阿托伐他汀与硝苯地平控释片联用及阿托伐他汀与培哚普利联用对原发性高血斥患者颈动脉内膜中层厚度（CIMT）和血管内皮功能的影响及临床意义。方法选择126例心血管危险分层中危以上的1、2级高血压患者，随机分为钙通道阻滞剂（calcium—channel blocker，CCB）组（40例），他汀＋血管紧张素转化酶抑制剂（angiotensin—converting enzyme inhibitor，ACEI）组（43例）及他汀＋CCB组（43例），分别于用药前和用药24周后测量血压，测定空腹静脉血总胆同醇（TC）、甘油二三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆同醇（HDL—C），以超声观察CIMT及肱动脉内皮依赖性舒张功能（FMD）的变化。结果三组收缩乐和舒张压均显著降低，他汀＋CCB组的收缩斥和舒张压下降更为显著。他汀＋ACEI组及他汀＋CCB组的TC和LDL—C均明显下降：三组FMD均显著改善，CIMT均显著减少，并且治疗后他汀＋CCB组与另两组比较，差异均有统计学意义。结论硝苯地平控释片与阿托伐他汀在降压、降脂、降低CIMT及改善血管内皮功能方面有协同作用。

Effect of nifedipine controlled released tablet and atorvastatin on carotid intimamedia thickness and vascular endothelial function in patients with hypertension

Objective To compare and observe the influences of Nifedipine Controlled Released Tablet, atorvastatin combined with Nifedipine Controlled Released Tablet or atorvastatin combined with perindopril on carotid intima-media thickness （ CIMT） and vascular endothelial function, and the clinical significance in the patients with primary hypertension. Methods The patients （n = 126） with 1 or 2 grade hypertension above mid-danger level after cardiovascular risk stratification were divided into the CCB group （ group 1, n = 40 ） ,atorvastatin ＋ ACEI group （ group 2, n = 43 ） and atorvastatin ＋ CCB group （ group 3, n = 43 ）. Before the treatment and in 24 weeks ＇after the treatment the blood pressure, and the levels of total cholesterol （TC）, triglyceride （ TG ）, low-density lipoprotein-cholesterol （ LDL-C ） and high-density lipoprotein-eholesterol （HDL-C） were detected respectively. The changes of CIMT and endothelium dependent flow mediated- dilatation （ FMD） of brachial artery were observed by using ultrasonic examination. Results In three groups the systolic pressure and diastolic pressure decreased significantly, especially in group 3. In group 2 and 3 the levels of TC and LDL-C decreased significantly. FMD was improved significantly and CIMT was reduced significantly in three groups. After the treatment the comparison between group 2 and group 1 or group 3 showed that the difference was significant statistically. Conclusion Nifedipine Controlled Released Tablet and atorvastatin have a synergism in the decreases of blood pressure,blood fat and CIMT, and ilnprovement of vessel endothelium.