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[目的]观察降压调脂联合治疗对正常血脂老年高血压患者血压血脂水平及脑血流动力学的影响。[方法]选择2005年9月至2008年9月到枣庄市立医院门诊及住院治疗的128例正常血脂老年高血压患者,给予降压调脂治疗12周,检测血压、血脂,经颅多谱勒超声(TCD)监测大脑中动脉、椎动脉和基底动脉的血流速度与血管搏动指数、阻力指数,并与30名老年健康体检者比较。[结果]治疗12周后,干预组128例中,血压达标的62例,占49.44%,其中血压、血脂水平均达标的占23.44%,血压达标、血脂未达标的占25.00%,血压未达标、血脂达标的占25.00%,血压、血脂均未达标的占26.56%。干预组治疗12周后,收缩压、舒张压、脉压差、总胆固醇略高于对照组(P<0.01)。脑血管TCD异常发生率,治疗前干预组为67.19%,对照组为10.00%(P<0.01);治疗后干预组为35.16%,对照组为6.67%(P<0.01);血压、血脂均达标组为10.00%,与对照组的差异无统计学意义(P>0.05)。[结论]降压调脂联合治疗正常血脂老年高血压患者,对于改善脑血流动力学,降低血压水平有一定效果。
[Objective] To observe the effects of antihypertensive and lipid-lowering combination therapy on blood pressure, blood lipid and blood flow in elderly patients with essential hypertension. [Methods] From September 2005 to September 2008, 128 cases of elderly patients with hypertension and outpatient treatment at Zaozhuang Municipal Hospital were treated with antihypertensive and lipid-lowering therapy for 12 weeks. Blood pressure, blood lipid, transcranial Doppler Ultrasound (TCD) was used to monitor the blood flow velocity, vascular pulsatility index and resistance index of middle cerebral artery, vertebral artery and basilar artery, and compared with 30 elderly healthy subjects. [Results] Twelve weeks after treatment, 62 patients (49.44%) met the standard of blood pressure in the intervention group, of which blood pressure and blood lipid reached the standard of 23.44%, blood pressure reached the standard, blood lipid did not meet the standard of 25.00%, blood pressure did not reach the standard , 25.00% of blood lipid compliance, blood pressure, blood lipid did not meet the standards of 26.56%. After 12 weeks of treatment, systolic blood pressure, diastolic blood pressure, pulse pressure and total cholesterol were slightly higher in the intervention group than those in the control group (P <0.01). The incidence of cerebrovascular TCD abnormalities was 67.19% in the intervention group and 10.00% in the control group (P <0.01), 35.16% in the intervention group and 6.67% in the control group (P <0.01) Group was 10.00%, no significant difference with the control group (P> 0.05). [Conclusion] The combination of antihypertensive and lipid-lowering therapy in elderly patients with normal blood lipid and hypertension has some effect on improving cerebral hemodynamics and lowering blood pressure.