阿司匹林联合阿托伐他汀治疗高血压合并糖尿病的疗效观察

Hongli Xing, Lifang Wang, Mei Ping, Yongping Jia
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摘要

目的探讨阿司匹林联合阿托伐他汀治疗高血压合并糖尿病的疗效。方法选择2016年1月至2017年12月山西医科大学附属第一医院收治的高血压合并糖尿病患者100例,按随机数字表法分为阿司匹林组和阿司匹林联合阿托伐他汀组(联合治疗组),每组50例。阿司匹林组患者给予阿司匹林100 mg/d;联合治疗组给予阿司匹林100 mg/d,阿托伐他汀20 mg/d。测量两组患者治疗前及治疗后20周的血脂、尿白蛋白、β2-微球蛋白(β2-MG)、尿白蛋白排泄率(UAER)、心踝血管指数(CAVI)、踝肱指数(ABI),并通过随访比较分析两组患者非致死性心肌梗死的发生率。结果与术前比较,两组患者治疗后总胆固醇、低密度脂蛋白胆固醇水平均降低,CAVI、ABI水平均改善(P < 0.05)。联合治疗组治疗后尿白蛋白、甘油三酯、UAER、β2-MG均降低(P<0.05)。中位随访期间,阿司匹林组非致死性心肌梗死主要终点发生率高于联合治疗组(P<0.05)。多元逐步回归分析显示,舒张压、收缩压、餐后2 h血糖和空腹血糖是动脉僵硬度和微量白蛋白尿的危险因素。结论阿司匹林与阿托伐他汀联合应用可显著降低高血压合并糖尿病患者尿微量蛋白水平,缓解动脉僵硬,有效降低非致死性心肌梗死的发生率。研究发现,动脉僵硬度和微量白蛋白尿与血压和血糖水平有直接关系。关键词:阿司匹林;阿托伐他汀;高血压;糖尿病;动脉硬化;非致死性心肌梗死
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of aspirin combined with atorvastatin on hypertensive patients with diabetes mellitus
Objective To investigate the effects of aspirin combined with atorvastatin on hypertensive patients with diabetes mellitus. Methods One hundred hypertensive patients with diabetes mellitus admitted to the First Hospital of Shanxi Medical University from January 2016 to December 2017 were selected and divided into aspirin group and aspirin combined with atorvastatin group (combined treatment group) according to random number table method, with 50 cases in each group. Patients in aspirin group were treated with aspirin, 100 mg/d; while patients in combined treatment group were treated with aspirin, 100 mg/d, and atorvastatin, 20 mg/d. Blood lipid, urinary albumin, β2-microglobulin (β2-MG), urinary albumin excretion rate (UAER), cardioankle vascular index (CAVI) and ankle brachial index (ABI) of the two groups were measured and compared before and 20 weeks after treatment, and the incidences of non fatal myocardial infarction of the two groups were compared and analyzed by follow-up. Results Compared with preoperative levels, the levels of total cholesterol and low-density lipoprotein cholesterol of the two groups were reduced, and the levels of CAVI and ABI were improved after treatment (P 0.05). However, the urinary albumin, triacylglycerol, UAER and β2-MG in the combined treatment group were decreased after treatment (P<0.05). During the median follow-up period, the incidence of major endpoints in non fatal myocardial infarction in aspirin group was higher than that in combined treatment group (P<0.05). Multiple stepwise regression analysis showed that the risk factors of arterial stiffness and microalbuminuria were diastolic pressure, systolic pressure, 2 h postprandial blood glucose and fasting blood glucose. Conclusions The combined use of aspirin and atorvastatin can significantly reduce the level of urinary microprotein in patients with hypertension and diabetes mellitus, alleviate arterial stiffness, effectively reduce the incidence of non fatal myocardial infarction. And the study finds that arterial stiffness and microalbuminuria are directly related to blood pressure and blood glucose level. Key words: Aspirin; Atorvastatin; Hypertension; Diabetes mellitus; Arterial stiffness; Non fatal myocardial infarction
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