阿托伐他汀钙对高血压视网膜病变的治疗作用

裴芳; 黄骥; 李锐锋; 黄婕; 唐素琼; 李琳; 陈诗佳; 谷君; 王雅佗; 肖睿

doi:10.13201/j.issn.1001-1439.2016.10.014

阿托伐他汀钙对高血压视网膜病变的治疗作用

- 1 中国人民武装警察部队重庆市总队医院心内科(重庆, 400061);
- 2 中国人民武装警察部队重庆市总队医院眼科中心
基金项目:
国家自然科学基金(No:81200193)

重庆市卫生计生委医学科研项目(No:20142230)

详细信息

通讯作者: 黄骥,E-mail:huangji6905@163.com

中图分类号: R544.1

收稿日期: 2016-06-28

修回日期: 2016-08-08

Therapeutical effect of atorvastatin on patients with hypertensive retinopathy

- 1 Department of Cardiology,;
- 2 Department of Ophthalmology, Chongqing Municipal Corps Hospital of Chinese People's Armed Police Force, Chongqing, 400061, China

More Information

Corresponding author: HUANG Ji, E-mail: huangji6905@163.com

Received Date: 28 June 2016

Revised Date: 08 August 2016

摘要

摘要: 目的:观察阿托伐他汀钙治疗原发性高血压视网膜病变(HR)的疗效。方法:将高血压合并视网膜病变患者238例随机分为常规治疗组106例与阿托伐他汀钙组132例,两组均给予相同的降压药物治疗,阿托伐他汀钙组在此基础上加用阿托伐他汀钙治疗。观察患者用药前和用药后6、12、24个月的血压、BMI、血脂、视力、眼底视网膜以及视觉电生理各项参数变化情况。结果:两组患者治疗后收缩压(SBP)和舒张压(DBP)均较治疗前显著下降(均P<0.001),视力、眼底视网膜病变及视觉电生理各项参数均明显改善(均P<0.05),且疗程越长,上述差异越大。和同期常规治疗组比较,阿托伐他汀钙组能更有效控制血压、血脂和BMI(均P<0.05),但血压下降与其调脂作用无显著相关性。自用药后12个月起,阿托伐他汀钙组在提高视力、眼底视网膜病变缓解程度以及视觉电生理各项指标改善方面明显优于同期的常规治疗组(均P<0.05),用药后24个月上述差异更显著(均P<0.01)。多因素回归分析显示,基线SBP、DBP和三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)是与HR相关的独立危险因素(均P<0.05)。主成分Logistic回归分析显示,SBP、DBP、TC和LDL-C的下降幅度,以及阿托伐他汀钙的应用是影响HR治疗效果的主要因素(均P<0.05)。结论:阿托伐他汀钙协同降压药物治疗安全性高,可能通过调脂和协同降压作用提高了HR的治疗疗效。
- 阿托伐他汀钙 /
- 高血压 /
- 原发性 /
- 视网膜病变
Abstract: Objective:To observe the therapeutical effect of atorvastatin on hypertensive retinopathy(HR).Method:We enrolled 238 patients with essential hypertension complicated with HR.The patients were randomly divided into two groups,namely routine group(n=106)and atorvastatin group(n=132).The patients of two groups were given the same oral antihypertensive medicine.On the basis,the patients in the atorvastatin group were treated with atorvastatin.The changes of blood pressure,BMI,blood lipid,retinopathy,vision and visual electrophysiology were observed and analyzed before and after 6,12,24 months of treatment.Result:After treatment by atorvastatin,the systolic blood pressure(SBP),diastolic blood pressure(DBP),BMI,serum total cholesterol(TC),triglycerides(TG)and low-density lipoprotein cholesterol(LDL-C)levels decreased significantly,compared with those before treatment(all P<0.001)and the corresponding period in routine group(all P<0.05).The same trend was reflected in the improvement of vision and high-density lipoprotein cholesterol(HDLC)levels,the relief of retinopathy,and the changes of visual electrophysiology,the differences were all statistically significant(all P<0.05).The longer the treatment time,the more obvious the effect.However,there was no correlation between antihypertensive and lipid-lowering effect of atorvastatin.Multiple regression analysis showed that baseline levels of SBP,DBP,serum TC,TG,HDL-C and LDL-C were independently correlated with HR(all P<0.05).Principle components-logistic regression analysis showed that the decrease range of the SBP,DBP,TC and LDL-C and the trealment of atorvastatin were the main independent influence factors for the treatment effect of HR(all P<0.05).Conclusion:Atorvastatin therapy on the basis of conventional anti-hypertensive drugs can obviously improve the effect in the treatment of HR with a fair safety and tolerance,which may be possible due to regulate lipid level and produce a synergistic antihypertensive effect on patients with essential hypertension.
- atorvastatin /
- hypertension /
- essential /
- retinopathy

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