阿托伐他汀钙对不同海拔地区高脂血症并高粘血症患者血脂及血液流变学的干预研究

目的探讨阿托伐他汀钙对不同海拔地区高脂血症并高粘血症患者血脂及血液流变学指标的影响。方法应用阿托伐他汀钙20 mg分别干预2周、4周后再测血脂及血液流变学指标,并对干预前后各组间血脂、血液流变学结果进行比较。结果①居住在海拔2260 m的高脂血症并高粘血症患者应用阿托伐他汀钙治疗2周、4周后与治疗前比较：总胆固醇、甘油三酯、低密度脂蛋白、全血粘度（低切、高切）、全血还原粘度（低切、高切）明显降低,差异有显著性（P〈0.05）;治疗4周与治疗2周比较：总胆固醇、低密度脂蛋白、全血粘度（低切、高切）、全血还原粘度（低切、高切）均下降,差异有显著性（P〈0.05）。②居住在玉树州结古镇（海拔3681m）、果洛州大武镇（海拔3719m）高脂血症并高粘血症患者应用阿托伐他汀钙治疗2、4周后较治疗前比较：总胆固醇、低密度脂蛋白有显著下降,治疗4周后与2周比较总胆固醇下降显著;血液流变学指标均有下降趋势但无显著差异（P〉0.05）。结论①阿托伐他汀钙可纠正海拔2260 m高脂血症并高粘血症患者血脂紊乱及改善血液流变性,并与用药时间呈正相关;②阿托伐他汀钙能够纠正海拔3000 m以上高脂血症并高粘血症患者的血脂紊乱,而对高粘血症改善不明显。考虑高原低氧可能是该类患者血液粘稠度增高的主要因素之一,因此对海拔3000 m以上的高脂血症并高粘血症患者单纯的调节血脂治疗不能改善血液粘度。

THE EFFECTS OF ATORVASTATIN CALCIUM ON BLOOD LIPID AND HEMORHEOLOGY IN PATIENTS WITH HYPERLIPIDEMIA AND HYPERVISCOSAEMIA AT DIFFERENT ALTITUDE

Objective To study the effects of Atorvastatin Calcium onblood lipid and hemorheology in patients with hyperlipidemia and hyperviscosaemia at different altitude.Methods 195 patients with hyperlipidemia and hyperviscosaemia at different altitudes were treated with Atorvastatin Calcium for 2 weeks and 4 weeks.The blood lipid and all parameters of hemorheology were measured before and after treatment.Results ①The levels of serum total cholesterol,triglyceride,low density lipoprotein cholesterol were significantly reduced after 2 weeks and 4 weeks of treatment in patients lived on the altitude of 2260m（P0.05）;Atorvastatin Calcium could greatly decrease the low shear and high shear of blood specific viscosity,reduction viscosity in patients lived on the altitude of 2260m（P0.05）.Comparison of the groups after 2 weeks treatment,the levels of serum total cholesterol,low density lipoprotein cholesterol,low shear and high shear of blood specific viscosity,reduction viscosity were significantly reduced in patients lived on the altitude of 2260m after treated for 4 weeks（P0.05）,With the increase of treatment time,the effects was remarkable.②The levels of serum total cholesterol,low density lipoprotein cholesterol were significantly reduced after treated for 2 weeks or 4 weeks in patients lived on the altitude 3000m（P0.05）;to compare the groups of after treatment 2weeks,the levels of serum total cholesterol were significantly reduced in patients lived on the altitude 3000m after treatment 4 weeks（P0.05）,but all parameters of hemorheology were no significant changes（P0.05）.Conclusion ①Atorvastatin Calcium not only can regulate the blood lipid,but also can improve hemorheology in patients lived on the altitude of 2260m;②Atorvastatin Calcium can regulate blood lipid,but can not improve hemorheology in patients lived on the altitude 3000m.We consider that the chief reason of hyperviscosaemia in patients lived on the altitude 3000m is hypoxia.So it shows that it is not the only ways to regulate blood lipid in patients lived on the altitude 3000m with hyperlipidemia and hyperviscosaemia.