阿托伐他汀、氟伐他汀对轻中度高血压合并高脂血症患者血管弹性功能的改善作用

目的探讨阿托伐他汀和氟伐他汀两种他汀药对于轻中度高血压合并高脂血症患者动脉弹性功能的改善作用。方法选择2009年1月～2011年1月我院治疗的轻中度高血压合并高脂血症患者80例,随机分为阿托伐他汀、氟伐他汀两个治疗组,每组各40例。在治疗前和治疗4、12周后测量患者的臂踝脉搏波传导速度（baPWV）及血脂情况。结果①他汀治疗后两组的胆固醇（TC）、低密度脂蛋白（LDL-C）、三酰甘油（TG）均较治疗前明显降低,差异有高度统计学意义（P〈0.01）;②两组baPWV水平他汀治疗后均有所下降,治疗前阿托伐他汀、氟伐他汀组baP-WV分别为（1 725.97±264.46）、（1 778.74±305.74）cm/s,治疗4周后分别为（1 680.03±249.62）、（1 749.00±256.88）cm/s,治疗12周后分别为（1 632.65±248.24）、（1 697.97±268.22）cm/s,治疗4、12周后两组baPWV水平与治疗前均降低,差异均有统计学意义（P〈0.05或P〈0.01）,治疗12周后baPWV水平低于治疗4周后,差异有高度统计学意义（P〈0.01）;③两组治疗12周后baPWV差值（△baPWV12）高于治疗4周后baPWV差值（△baPWV4）,差异有统计学意义（P〈0.05）,但在两组间比较差异无统计学意义（P〉0.05）。结论①应用阿托伐他汀、氟伐他汀治疗均能改善轻中度高血压合并高脂血症患者动脉弹性功能;②长期应用阿托伐他汀、氟伐他汀治疗对于动脉弹性存在持续的改善作用;③他汀治疗4、12周时,阿托伐他汀改善动脉弹性的作用可能更为明显,但在本研究中两组间比较差异无统计学意义（P〉0.05）,需要进一步的研究。

Elastic improvement of Atorvastatin and Fluvastatin in arterial stiffness in patients with hypertension and hyperlipidemia

Objective To investigate the effect of Atorvastatin and Fluvastatin on improving the artery stiffness in patients with hypertension and hyperlipidemia.Methods 80 patients with hypertension and hyperlipidemia in our hospital from January 2009 to January 2011 were selected and randomly assigned to Atorvastatin group（10 mg/day） and Fluvastati group（20 mg/day） with 40 patients in each group.Brachial-ankle pulse wave velocity（baPWV） and blood fat were measured before the treatment and 4,12 weeks after the treatment.Results ① TC,LDL-C and TG after the treatment in the two groups were lower than those before the treatment,the difference were statistically significant（P 0.01）;② BaPWV after the treatment in the two groups were lower than those before the treatment,baPWV was（1 725.97±264.46） and（1 778.74±305.74）cm/s before the treatment in the Atorvastatin group and Fluvastatin group respectively,baPWV was（1 680.03±249.62） and（1 749.00±256.88） cm/s after 4 weeks treatment,baPWV was（1 632.65±248.24）,（1 697.97±268.22） cm/s after 12 weeks treatment,baPWV in the two groups after 4 weeks and 12 weeks treatment were lower than those before the treatment,the differences were statistically significant（P 0.05 or P 0.01）,baPWV after 12 weeks treatment was lower than that after 4 weeks treatment,the difference was statistically significant（P 0.01）;③ The changes of baPWV after 12 weeks treatment were higher than those after 4 weeks treatment,the difference was statistically significant（P 0.05）,but the difference between the two groups was not statistically significant（P 0.05）.Conclusion ① Atorvastatin and Fluvastatin therapy have the advantage of elastic improvement in patients with hypertension and hyperlipidemia;② Continuous therapy of Atorvastatin and Fluvastatin have the continuous advantage of elastic improvement;③ Elastic improvement of Atorvastatin therapy may be more obvious,but the difference between the two groups was not statistically significant（P 0.05）,it needs further study.