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目的通过应用瑞舒伐他汀对高血压合并颈动脉斑块的患者进行干预,观察其对血脂、斑块及缺血性卒中发生率的影响。方法选取2013年5月—2015年5月就诊于邯郸市第一医院存在颈动脉斑块的高血压患者255例,随机分为对照组、瑞舒伐他汀低规剂量组(观察1组)和常规剂量组(观察2组),每组85例,均给予降压治疗及生活方式干预,对照组口服与瑞舒伐他汀相同外观的安慰剂1片,观察1组口服瑞舒伐他汀5 mg/d,观察2组口服瑞舒伐他汀10 mg/d,随访6个月。治疗前及治疗后检测血脂、血压,颈部血管超声检测颈动脉内膜-中膜厚度(iatima-media thickness,IMT)、斑块面积和Crouse斑块积分。比较治疗6个月后的脑缺血事件发生率。结果对照组治疗前、后各指标水平比较差异无统计学意义(P>0.05);治疗后观察1组、观察2组收缩压、舒张压均较治疗前下降,但差异无统计学意义(P>0.05);观察1组、观察2组治疗后TC水平较治疗前明显下降,IMT、斑块面积、Crouse积分、易损斑块率较治疗前降低,差异均有统计学意义(P<0.05),且观察2组各指标改善较观察1组明显(P<0.05)。结论瑞舒伐他汀除具有降脂作用外,还能逆转和稳定斑块,减少缺血性卒中事件的发生,且与剂量呈正相关。
Objective To investigate the effect of rosuvastatin on the incidence of lipids, plaque and ischemic stroke in patients with hypertension complicated with carotid artery plaque. Methods A total of 255 hypertensive patients with carotid artery plaque in the First Hospital of Handan from May 2013 to May 2015 were randomly divided into control group, rosuvastatin low dose group (observation group 1) and control group The conventional dose group (observation 2 groups), 85 cases in each group, were given antihypertensive treatment and lifestyle intervention, the control group oral rosuvastatin orally the same placebo 1 observed rosuvastatin 5 mg / d, observed two groups of oral rosuvastatin 10 mg / d, followed up for 6 months. Before treatment and after treatment, blood lipids, blood pressure and cervical vascular ultrasound were used to detect carotid artery intima - media thickness (IMT), plaque area and Crouse plaque score. The incidence of ischemic events after 6 months of treatment was compared. Results Before and after treatment, there was no significant difference between the two groups (P> 0.05). After treatment, 1 group was observed. Systolic blood pressure and diastolic blood pressure were decreased in both groups compared with before treatment, but the difference was not statistically significant (P> 0.05) > 0.05). In observation group 1, TC levels in the two groups were significantly lower than those before treatment, and the IMT, plaque area, Crouse score and vulnerable plaque rate were significantly lower than those before treatment (P <0.05 ), And the observation of two groups of indicators improved more significantly than the observation group 1 (P <0.05). Conclusion Rosuvastatin, in addition to lipid-lowering effect, can also reverse and stabilize the plaque and reduce the incidence of ischemic stroke, and is positively correlated with the dosage.