摘要
目的观察在常规降压药物治疗的基础上加用阿托伐他汀对原发性高血压性视网膜病变(HR)患者视觉电生理的影响和疗效。方法将原发性高血压合并视网膜病变患者238例,随机分为阿托伐他汀组132例与常规治疗组106例。两组均给予相同的降压药物治疗,阿托伐他汀组在此基础上加用阿托伐他汀治疗。对比观察两组患者用药前和用药后6个月、12个月、24个月闪光视网膜电图(FERG)a波、b波和振荡电位(OP)的变化情况。结果两组患者治疗后收缩压(SBP)和舒张压(DBP)均较治疗前显著下降(P<0.001),FERG中a波、b波、OP及各子波潜伏期均显著缩短(P<0.05或P<0.001),振幅显著延长(P<0.05或P<0.001),且疗程越长,上述差异越大。与同期常规治疗组比较,阿托伐他汀组能更有效控制血压、血脂和体质指数(P<0.05或P<0.001),但血压下降与其降脂作用无显著相关性(P>0.05)。自用药后12个月起,阿托伐他汀组FERG中a波、b波、OP及各子波潜伏期均显著短于常规治疗组(P<0.05或P<0.01),振幅均显著长于常规治疗组(P<0.05或P<0.01),用药后24个月上述差异更明显(P<0.01或P<0.001)。主成分Logistic回归分析显示SBP、DBP、总胆固醇、低密度脂蛋白胆固醇的下降幅度及阿托伐他汀的应用是影响HR患者视觉电生理改善的主要因素(P<0.05或P<0.001)。结论阿托伐他汀协同降压药物治疗提高了HR的疗效,使异常的视觉电生理得到改善。
Aim To observe the therapeutical effect of atorvastatin taken orally together with antihypertensive medicine on visual electrophysiological changes in patients with hypertensive retinopathy（ HR）. Methods 238 patients with essential hypertension complicated with retinopathy were enrolled in the study,and were randomly divided into atorvastatin group（ 132 cases） and the conventional treatment group（ 106 cases）. The patients of two groups were given the same oral antihypertensive medicine. On the basis,the patients in the atorvastatin group were treated with atorvastatin.The changes of flash electroretinogram（ FERG） a-wave,b-wave and oscillatory potential（ OP） were observed and compared before and after 6,12,24 months of treatment in the two groups. Results In the two groups,after treatment,systolic blood pressure（ SBP） and diastolic blood pressure（ DBP） were significantly lower than those before treatment（ P〈0. 001）,FERG a-wave,b-wave,OP and the wavelets latent periods were significantly shortened（ P〈0. 05 or P〈0. 001）,the amplitudes were significantly prolonged（ P〈0. 05 or P〈0. 001）,and the longer the duration,the greater the difference.Compared with the same period conventional treatment group,blood pressure,blood lipid and body mass index could be effectively controlled in atorvastatin group（ P〈0. 05 or P〈0. 001）,but blood pressure decline did not significantly correlatewith the lipid-lowering effect（ P〉0. 05）. 12 months after drug use,compared with conventional treatment group,FERG a-wave,b-wave,OP and the wavelets latent periods were significantly shortened（ P〈0. 05 or P〈0. 01）,the amplitudes were significantly prolonged（ P〈0. 05 or P〈0. 01） in atorvastatin group,and 24 months after drug use,the above differences were more obvious（ P〈0. 01 or P〈0. 001）. Principal component Logistic regression analysis showed that the decrease range of SBP,DBP,total cholesterol,low density lipoprotein cholesterol and the application of atorvastatin were the main factors influencing the improvement of visual electrophysiology in patients with HR（ P〈0. 05 or P〈0. 001）.Conclusion Atorvastatin therapy on the basis of conventional anti-hypertensive drugs can obviously improve the effect in the treatment of HR with the improvement of visual electrophysiology.
作者
裴芳
黄骥
李锐锋
李琳
唐素琼
黄婕
肖睿
陈诗佳
王雅佗
谷君
PEI Fang HUANG Ji LI Rui-Feng LI Lin TANG Su-Qiong HUANG Jie XIAO Rui CHEN Shi-Jia WANG Ya-Tuo GU Jun(Department of Cardiology Department of Ophthalmology, Chongqing Municipal Corps Hospital of Chinese People＇s Armed Police Force, Chongqing 400061, China)
出处
《中国动脉硬化杂志》
CAS
北大核心
2016年第10期994-1000,共7页
Chinese Journal of Arteriosclerosis
基金
国家自然科学基金项目(81200193)
重庆市卫生计生委医学科研项目(20142230)
