本文關(guān)鍵詞： 阿托伐他汀 依折麥布 血脂 血清炎癥因子 頸動脈粥樣硬化斑塊　出處：《昆明醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：[目的]探究阿托伐他汀與依折麥布聯(lián)合治療對高血壓合并糖尿病患者血脂、血清中炎癥因子及頸部動脈粥樣硬化斑塊的影響。[方法]選取2015年8月-2016年5月期間,在昆明醫(yī)科大學附屬甘美醫(yī)院心內(nèi)科門診或住院部就診,行頸動脈彩色多普勒超聲檢查提示有頸動脈粥樣硬化斑塊的高血壓合并糖尿病患者100例為研究對象,通過抽簽的方式隨機將所有入選患者分為治療組A組及對照組B組,兩組均為50例研究對象。收集所有入選者的基本資料含概性別、年齡、體重指數(shù)(body mass index,BMI)、有無煙酒史,血液檢測資料包括甘油三酯(triglyceride,TG)、總膽固醇(total cholesterol,TC)、高密度脂蛋白膽固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白膽固醇(low-density lipoprotein cholesterol,LDL-C)、空腹血糖(fasting blood glucose,FBG)、血漿糖化血紅蛋白(hemoglobinAlC,HbA1C)以及高敏 C 反應(yīng)蛋白(high-sensitive C-reactive protein,hs-CRP),其他資料還包含:患者血壓(收縮壓(systolic blood pressure,SBP),舒張壓(diastolic blood pressure,DBP)),頸動脈內(nèi)-中膜厚度(carotid intima-media thickness,CIMT),過程中嚴密監(jiān)測患者的肝腎功能、藥物不良反應(yīng)及有無相關(guān)并發(fā)癥。A組采用阿托伐他汀鈣片20mg+依折麥布10mg聯(lián)合治療,B組采用單一阿托伐他汀鈣片20mg,經(jīng)過3個月治療后觀察對比兩組患者之間患者血脂、血清炎癥因子及頸動脈內(nèi)-中膜厚度的變化情況;若差異無明顯統(tǒng)計學意義則適當延長隨訪時間。[結(jié)果]3個月后,A、B兩組患者的總膽固醇、甘油三醋、低密度脂蛋白膽固醇、高敏C反應(yīng)蛋白均較治療前下降,且A組下降幅度大于B組(P0.05),差異有統(tǒng)計學意義。兩組高密度脂蛋白膽固醇含量較前升高(P0.05),差異不具有明顯統(tǒng)計學意義。頸動脈內(nèi)-中膜厚度較前稍減輕(P0.05),差異無統(tǒng)計學意義。后延長頸動脈內(nèi)-中膜厚度隨訪時間,經(jīng)10個月跟蹤隨訪后,2組頸動脈內(nèi)-中膜厚度較前明顯減輕(P0.05),差異有明顯統(tǒng)計學意義。[結(jié)論]高血壓合并糖尿病患者使用阿托伐他汀聯(lián)合依折麥布治療可以更好的降低血脂、血清炎癥因子水平,改善頸部動脈血管內(nèi)-中膜厚度,最終減慢動脈粥樣硬化的進展,甚至可以逆轉(zhuǎn)斑塊形成。
[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.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R544.1;R587.1

【參考文獻】

相關(guān)期刊論文 前10條

1 隋輝;陳偉偉;王文;;《中國心血管病報告2015》要點解讀[J];中國心血管雜志;2016年04期

2 王煥兵;;阿托伐他汀聯(lián)合依折麥布對老年高血壓患者血脂及炎性因子水平的影響[J];中國醫(yī)學前沿雜志(電子版);2016年08期

3 劉蓓;;2型糖尿病合并高血壓的研究概況[J];海峽藥學;2016年05期

4 周運東;鄧永宏;陳玉環(huán);李少霞;肖義森;文武軍;;依折麥布聯(lián)合阿托伐他汀對2型糖尿病患者頸動脈粥樣斑塊的影響[J];中外醫(yī)學研究;2014年19期

5 胡小菁;遲麗屹;張文韜;段寧;馮占斌;;動脈粥樣硬化炎癥機制及阿托伐他汀藥物多樣性的研究進展[J];心血管病學進展;2014年02期

6 杜曉明;劉立民;龐露;麥合木提·麥提如則;孫浩;菅凌燕;;阿托伐他汀聯(lián)合依折麥布調(diào)血脂療效的Meta分析[J];中國醫(yī)院藥學雜志;2012年20期

7 金雅磊;王樺;程新耀;;冠心病高危人群頸動脈內(nèi)中膜離散度變化及相關(guān)因素[J];中華實驗外科雜志;2012年05期

8 姚海丹;;高血壓患者血壓水平與頸動脈內(nèi)膜中層厚度的關(guān)系[J];淮海醫(yī)藥;2011年05期

9 項榮;郭紅山;孫開琪;;血小板:動脈粥樣硬化的誘導者和推動者[J];中國細胞生物學學報;2010年05期

10 羅萍;杜松;段紅艷;;阿托伐他汀聯(lián)合依折麥布對老年高膽固醇血癥患者頸動脈硬化的影響[J];中國循環(huán)雜志;2010年03期

，

本文編號：1479882