目的 探讨不同剂量阿托伐他汀对老年人高血压患者血脂水平及超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)等炎性因子的影响。方法 将120例老年高血压患者随机分为对照组、治疗1组和治疗2组,3组均接受常规治疗,治疗1组和治疗2组在常规治疗基础上睡前分别口服阿托伐他汀10 mg/d和20 mg/d,均在入院48 h内开始用药,治疗8周。统计3组患者入院24 h内及治疗12周后的血压、血脂、hs-CRP、IL-6、TNF-α的相关数据并进行比较。结果 与治疗前比较,3组治疗后血压均明显下降(均P＜0.05)。3组TC、LDL-C、hs-CRP、IL-6 和TNF-α均有不同程度的下降,对照组、治疗1组和治疗2组治疗后的TC分别为(5.89±0.53) mmol/L、(5.11±0.53) mmol/L和(4.92±0.23) mmol/L,相应3组治疗后的LDL-C分别为(3.09±0.71) mmol/L、(2.69±0.33)mmol/L和(2.21±0.31) mmol/L,而hs-CRP分别为(6.84±0.63) mg/L、(5.79±0.98 )mg/L和(4.49±1.01) mg/L。与对照组比较,治疗1 组的TC、LDL-C、hs-CRP水平明显降低(P＜0.05),且治疗2组的LDL-C、hs-CRP 水平明显低于治疗1组(P＜0.05)。结论 阿托伐他汀能显著降低老年高血压患者血脂水平及炎性因子水平,剂量20 mg/d比10 mg/d效果更好。

Objective To investigate the influence of different doses atorvastatin on the serum lipid and high sensitive C-reactive protein ( hs-CRP ),IL-6,TNF-α in elderly patients with hypertension.Methods 120 elderly patients with hypertension were divided into three groups randomly: the control group,the atorvastatin treatment group 1 ( 10 mg/d) and the atorvastatin treatment group 2 ( 20 mg/d) . Each group received regular anti-hypertension treatment,the atorvastatin treatment groups were administered atrovastatin orally. Therapeutic time was 8 weeks. Blood pressure,TC,LDL-C,hs-CRP,IL-6,TNF-α contents were measured before and after therapy. Results Compared with before treatment, in the three groups after treatment, systolic blood pressure and diastolic blood pressure were significantly decreased (P<0.05). In the three groups of patients, TC, LDL-C, hs-CRP, IL-6 and TNF alpha all had varying degrees of decline, in treatment group 1 and group 2 decreased more significantly (P<0.05). TC in control group and treatment groups 1 and 2 were (5.89±0.53) mmol/L,(5.11±0.53) mmol/L and(4.92±0.23) mmol/L after treatment,respectively; LDL-C were(3.09±0.71) mmol/L,(2.69±0.33)mmol/L and(2.21±0.31) mmol/L; hs-CRP were(6.84±0.63) mg/L,(5.79±0.98 )mg/L and(4.49±1.01) mg/L. Compared with control group, in the two treatment groups, TC, LDL - C, hs CRP, IL 6 and TNF alpha significantly reduced, treatment 1 set of TC, LDL-C, hs-CRP significantly decreased (P<0.05). In treatment group 2, LCL-C and hs-CRP were significantly lower than in treatment group 1 (P< 0.05). Conclusions Atorvastatin can significantly reduce blood fat levels and inflammatory factor levels in the elderly patients with high blood pressure, and appropriate increase atorvastatin of dosage helps to improve curative effect, is worth promoting.