内科

目的探讨不同剂量阿托伐他汀对老年高血压患者血脂、超敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和血管内皮舒张功能的影响。方法将84例老年高血压患者随机分为对照组、治疗A组和治疗B组，三组患者均常规治疗，在此基础上治疗A组患者睡前口服阿托伐他汀10 mg/d，治疗B组患者睡前口服阿托伐他汀20 mg/d，均在入院48 h内开始用药，治疗8周。分别检测三组患者治疗前后的血压、血清总胆固醇（TC）、低密度脂蛋白-胆固醇（LDL-C）、hs-CRP、IL-6、TNF-α和血管内皮舒张功能的变化。结果与治疗前比较，三组患者治疗后收缩压和舒张压均显著下降（P＜0.05或P＜0.01）；三组患者TC、LDL-C、hs-CRP、IL-6和TNF-α均有不同程度的下降，治疗A组和B组下降更显著（P＜0.05或P＜0.01）；三组患者治疗后的血管内皮舒张功能均显著改善（P＜0.05或 P＜0.01）。与对照组比较，治疗B组TC、LDL-C、hs-CRP、IL-6、TNF-α显著降低治疗A组TC、LDL-C、hs-CRP明显降低（P＜0.05或P＜0.01）；治疗B组的LCL-C、hs-CRP显著低于治疗A组（P＜0.01）；治疗B组血管内皮舒张功能比治疗A组改善更明显（P＜0.01）。结论阿托伐他汀能显著降低老年高血压患者血脂水平及血管炎症反应，明显提高血管内皮舒张功能，20 mg/d剂量比10 mg/d剂量效果好。

ObjectiveTo investigate the influence of different doses atorvastatin on the serum lipid and High Sensitive C-Reactive Protein (hs-CRP),IL-6,TNF-α and endothelium-dependent vasodilation in elderly patients with hypertension.Methods84 elderly patients with hypertension were divided into three groups randomly:the control group,the atorvastatin treatment group A (10 mg/d) and the atorvastatin treatment group B (20 mg/d).Each group received regular anti-hypertension treatment,the atorvastatin treatment groups were administered orally atrovastatin. Therapeutic time was 8 weeks.Blood pressure,serum total cholesterol (TC),low density lipoprotein-cholesterol (LDL-C),hs-CRP,IL-6,TNF-α contents and endothelium-dependent vasodilation were measured before and after therapy.ResultsCompared with before therapy,blood pressure after therapy in the three groups were significantly decreased (P＜0.05 or P＜0.01).The TC,LDL-C,hs-CRP,IL-6,TNF-α after therapy in the three groups were decreased,and the atorvastatin treatment groups were significantly decreased (P＜0.05 or P＜0.01).The endothelium-dependent vasodilation was significantly improved in the three groups (P＜0.05 or P＜0.01).Compared with the control group,the TC,LDL-C and hs-CRP in groups A and B,the IL-6,TNF-α in the group B were significantly decreased (P＜0.05 or P＜0.01);Compared with the group A,hs-CRP,LDC-C in group B was significantly decreased (P＜0.01).The endothelium-dependent vasodilation in group B improved more significantly than group A.ConclusionAtorvastatin can effectively decrease the serum lipid,alleviate vascular in flammation response and improve endothelium-dependent vasodilation in elderly patients with hypertension,and the doses of 20 mg/d is better than 10 mg/d.