瑞舒伐他汀联合培哚普利对高血压患者 LDL-C 与 HDL-C 比值和颈动脉内膜中层厚度的影响

目的：探讨瑞舒伐他汀联合培哚普利对高血压患者低密度脂蛋白胆固醇（ LDL-C ）/高密度脂蛋白胆固醇（ HDL-C）和颈动脉内膜中层厚度（ IMT）的影响及二者之间的相关性。方法：入选初诊高血压伴高LDL-C血症患者126例，在给予基础降压治疗基础上随机分为治疗组63例（培哚普利＋瑞舒伐他汀治疗）和对照组63例（瑞舒伐他汀治疗）。比较治疗前和治疗3周后血压、LDL-C、HDL-C、LDL-C/HDL-C和IMT变化。结果：治疗后治疗组收缩压、舒张压和平均动脉压均较对照组下降明显（P＝0．012，P＝0．029，P＝0．037）。两组患者治疗前后LDL-C、HDL-C比较均没有统计学差异（P均＞0．05）。但治疗组治疗后LDL-C/HDL-C下降较对照组明显（P＝0．007），平均IMT和最大IMT均明显小于照组（ P＝0．001，P＜0．001）。治疗前后LDL-C/HDL-C差值与平均IMT差值呈正相关（ P＜0．001，r＝0．742）。结论：瑞舒伐他汀联合培哚普利可以逆转高血压伴高LDL-C血症患者颈动脉内膜斑块，二者联合使用对减少心脑血管疾病的发生有重要意义。

The Effect of Rosuvastatin Combined with Perindopril on LDL-C/HDL-C and Carotid Intima Media Thickness in Hypertension Patients

Objective：To investigate the efficacy of rosuvastatin combined with perindopril on LDL-C/HDL-C and carotid intima media thickness （ IMT） in hypertension patients, and the correlation between LDL-C/HDL-C and IMT.Method：A total of 126 high LDL-C patients with newly diagnosed hypertension＆amp;nbsp;were randomized to treatment group （n=63） and control group （n=63） after enrolled.On the basis of rou-tine antihypertensive therapy , treatment group received rosuvastatin treatment with the addition of perindopril and control group received rosuvastatin treatment only .Blood pressure , LDL-C, HDL-C, LDL-C/HDL-C and IMT were collected before and after 3 weeks treatment .Result：Systolic blood pressure （ SBP ） , dystolic blood pressure （ DBP ） , and mean blood pressure in treatment group were lower than that in control group af-ter treatment （P=0.012, P=0.029, P=0.037）.Blood levels of LDL-C and HDL-C were similar between the two groups （ all P＆gt;0.05） .But levels of LDL-C/HDL-C, mean IMT and MAX IMT in treatment group all decreased significantly after treatment compared to control group （ P=0.007, P=0.001, P＆lt;0.001）. Changes of LDL-C/HDL-C was positively correlated with changes of mean IMT （P＆lt;0.001,r=0.742）.Con-clusion：Rosuvastatin combined with perindopril can reverse carotid intima atherosclerosis in hypertension patients with high LDL-C.Both of them are closely correlated with preventing cardiovascular and cerebrovas-cular diseases .