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目的探讨阿托伐他汀对高血压伴糖耐量降低患者肱动脉直径及舒张功能的影响。方法选择2014年5月—2015年5月来本院就诊的70例高血压伴糖耐量降低患者作为研究对象,随机分为两组各35例。对照组给予常规降压治疗,试验组在常规治疗基础上联合阿托伐他汀治疗,观察两组治疗前后血压血糖、肱动脉直径和舒张功能变化情况。计量资料两组间比较采用独立样本t检验,组内比较采用配对t检验,P<0.05为差异有统计学意义。结果两组患者治疗前后舒张压(diastolic blood pressure,DBP)、收缩压(systolic blood pressure,SBP)、餐后2 h血糖(blood sugar 2 hours after meal,2 h PG)及空腹血糖(fasting plasma glucose,FPG)比较[(97.79±5.86)、(155.81±9.22)mm Hg(1 mm Hg=0.133 k Pa)、(9.82±1.01)、(5.82±0.57)mmol/L与(82.34±4.02)、(130.36±7.56)mm Hg、(9.23±0.84)、(5.13±0.46)mmol/L;(98.26±5.43)、(157.42±8.96)mm Hg、(9.75±0.98)、(5.78±0.50)mmol/L与(76.48±3.56)、(124.93±5.87)mm Hg、(8.67±0.73)、(4.85±0.34)mmol/L],差异均有统计学意义(t=12.862、12.628、2.657、5.573;19.845、17.944、5.229、9.099,均P<0.05)。治疗后试验组各指标显著低于对照组,差异均有统计学意义(均P<0.05)。两组患者治疗后血流介导的血管舒张功能(flow-mediated dilatation,FMD)水平[(7.86±0.51)、(10.52±0.38)%]均显著高于治疗前[(5.42±0.42)、(5.36±0.44)%],差异均有统计学意义(t=-52.508、-21.849,均P<0.05);治疗后试验组FMD显著高于对照组,差异有统计学意义(P<0.05)。结论阿托伐他汀可显著改善高血压伴糖耐量患者血压血糖异常状态,改善内皮细胞舒张功能。
Objective To investigate the effects of atorvastatin on brachial artery diameter and diastolic function in patients with hypertension and impaired glucose tolerance. Methods Seventy patients with hypertension with impaired glucose tolerance who visited our hospital from May 2014 to May 2015 were selected as study subjects and randomly divided into two groups of 35 cases each. The control group was given conventional antihypertensive treatment. The experimental group was treated with atorvastatin on the basis of routine treatment. The changes of blood pressure and blood pressure, brachial artery diameter and diastolic function were observed before and after treatment. Measurement data between the two groups using independent samples t test, the comparison of the group using paired t test, P <0.05 for the difference was statistically significant. Results Before and after treatment, diastolic blood pressure (DBP), systolic blood pressure (SBP), blood sugar 2 hours after meal (2 h PG) and fasting plasma glucose , FPG) were compared (97.79 ± 5.86), (155.81 ± 9.22) mm Hg (9.82 ± 1.01), (5.82 ± 0.57) mmol / L and (82.34 ± 4.02) 130.36 ± 7.56 mm Hg, 9.23 ± 0.84 and 5.13 ± 0.46 mmol / L respectively; (98.26 ± 5.43), (157.42 ± 8.96) mm Hg, (9.75 ± 0.98) and (5.78 ± 0.50) mmol / L And (76.48 ± 3.56), (124.93 ± 5.87) mm Hg, (8.67 ± 0.73) and (4.85 ± 0.34) mmol / L respectively. There were significant differences between the two groups (t = 12.862,12.628,2.657,5.573; 19.845, 17.944,5.229,9.099, all P <0.05). After treatment, the indexes in the experimental group were significantly lower than those in the control group (all P <0.05). The blood flow-mediated dilatation (FMD) levels in both groups were significantly higher than those before treatment [(5.42 ± 0.42), (7.86 ± 0.51), (10.52 ± 0.38)%] ( 5.36 ± 0.44)%], the differences were statistically significant (t = -52.508, -21.849, all P <0.05). After treatment, the FMD in the experimental group was significantly higher than that in the control group (P <0.05). Conclusions Atorvastatin can significantly improve the abnormal blood glucose and blood pressure in hypertensive patients with impaired glucose tolerance and improve the diastolic function of endothelial cells.