血脂清對高血壓合并代謝綜合征患者血脂及頸動脈內膜中層厚度的影響

[摘要] 目的 觀察中藥血脂清對高血壓合并代謝綜合征患者血脂及頸動脈內膜中層厚度的影響。 方法 將90例患者隨機分為3組，即阿托伐他汀組、血脂清組及聯合治療組，每組各30例。阿托伐他汀組予阿托伐他汀10 mg，每晚1次；血脂清組予血脂清1包，3次/d；聯合治療組予阿托伐他汀10 mg，每晚1次+血脂清1包，3次/d；療程均為8周。測定3組治療前后血脂、肝功能及IMT的變化，并計算IMT與頸總動脈管腔內徑的比率。 結果 與治療前比較，治療后3組TC、LDL-C、IMT均降低，血脂清組及聯合治療組TG降低，HDL-C升高，差異均有統計學意義（P<0.05）。治療后3組之間兩兩比較，TG、LDL-C降低差異無統計學意義（P>0.05）；TC降低，阿托伐他汀組、聯合治療組均優于血脂清組，差異有統計學意義（P<0.01），而阿托伐他汀組與聯合治療組之間比較，差異無統計學意義（P>0.05）；HDL-C升高，3組之間兩兩比較差異均有統計學意義（P<0.05），且聯合治療組優于血脂清組；IMT降低，聯合治療組均優于阿托伐他汀組、血脂清組，差異有統計學意義（P<0.01），而阿托伐他汀組與血脂清組比較，差異無統計學意義（P>0.05）。治療期間，阿托伐他汀組肝功能輕度升高3例，血脂清組及聯合治療組未見不良反應。 結論 血脂清可以有效調脂，與西藥阿托伐他汀聯合使用療效更佳，并可以顯著降低IMT，是治療高血壓合并代謝綜合征患者的一種有效方案。

[關鍵詞] 高血壓；代謝綜合征；血脂清；頸動脈內膜中層厚度

[中圖分類號] R544.1 [文獻標識碼] A [文章編號] 2095-0616（2012）21-21-03

Influence of xuezhiqing on blood lipid and carotid intima-media thickness of patients with hypertension with metabolic syndrome

CHEN Wenxin1，2 LIU Dehuan2 SU Qi1 YE Jing2 OU Lingjun2 WU Zhiyang2

1. Medical and Pharmaceutical Institute of Quanzhou City in Fujian Province， Quanzhou 362000， China；2.First Department of Interna1 Medicine， the Quanzhou Traditional Chinese Medicine Hospital Affiliated of Fujian University of Traditional Chinese Medicine， Quanzhou 362000， China

[Abstract] Objective To observe the influence of xuezhiqing on blood lipid and carotid intima-media thickness of patients with hypertension with metabolic syndrome. Methods 90 patients were randomly divided into 3 groups， of which each group got 30 patients for this study project including atorvastatin group （atorvastatin 10 mg qn）， XZQ group （XZQ 1 bag tid） and combined treatment group （atorvastatin 10 mg qn+XZQ 1 bag tid）. The treatment course of 3 groups was 8 weeks. The blood lipid， hepatic function and carotid intima-media thickness were determined before and after treatment in 3 groups. Results After treatment， TC， LDL-C and IMT were significantly decreased in 3 groups， TG decreased and HDL-C increased in XZQ group and combined treatment group， as compared with those before treatment （P<0.05）.The difference of TG and LDL-C did not reach a significant value between the 3 groups at post-treatment （P>0.05）.The atorvastatin group and combined treatment group were both superior to XZQ group in decreasing effect of TC（P<0.01），but no significant differences were detected between atorvastatin group and combined treatment group（P>0.05）. The increasing effect of HDL-C had statistical significances in the pair wise comparison among the three groups （P<0.05）， in which the combined treatment group better than the XZQ group. And the combined treatment group was better than the other two groups， which had no statistical significance， in the decreasing effect of IMT. There were only 3 cases of elevated liver function in atorvastatin group among all the patients during the treatment period. Conclusion XZQ can correct the abnormal blood lipid and the effect will be better， that can also decrease significantly IMT on combined with atorvostatin， which is an effective therapy on patients with hypertension with metabolic syndrome.

[Key words] Hypertension； Metabolic syndrome； Xuezhiqing； Carotid intima-media thickness

高血壓病（essential hypertension，EH）是心腦血管疾病的重要危險因素，流行病學研究發現，在EH患者中，代……