【摘要】 目的探讨在降血压治疗的同时联合应用辛伐他汀和阿司匹林对高血压合并无症状性大脑中动脉狭窄患者的干预作用和脑血管事件的预防效果。方法177例高血压合并大脑中动脉狭窄患者,其中90例应用辛伐他汀(每晚20mg)和阿司匹林肠溶片(75mg/d)进行治疗(干预组),通过经颅多普勒超声检查分别观察治疗前及治疗后1～3年大脑中动脉收缩期血流速度峰值、搏动指数、阻力指数、频谱形态,同时检测治疗前后血压、血脂等项生化指标的变化,并与87例对照者进行比较。结果治疗第1年,干预组患者大脑中动脉收缩期血流速度峰值、搏动指数、阻力指数及频谱形态等与治疗前差异无统计学意义(P>0.05);随访至第2,3年,上述各项指标均改善(P<0.01),频谱形态明显好转。随访结束时,两组患者大脑中动脉上述指标间差异有高度统计学意义(均P<0.01),干预组患者脑血管事件发生率为11.11%(10/90),低于对照组的24.14%(21/87)(P<0.01)。结论在有效降低血压的同时,联合应用辛伐他汀和阿司匹林可稳定并延缓高血压患者大脑中动脉狭窄的进程,对降低脑血管事件的发生率具有良好的作用。更多还原

【Abstract】 Objective To investigate the intervention efficacy of simvastatin and aspirin therapy on asymptomatic middle cerebral artery (MCA) stenosis in hypertension patients treated with antihypertensive agents. Methods Among 177 hypertension patients concomitant with MCA stenosis treated by antihypertensive agents, 90 were assigned into intervention group treated with both simvastatin 20 mg, every evening and aspirin (75 mg/d) for 3 years, and 87 were served as controls. Transcranial dopple (TCD), blood pressure, and biochemical indexes (e.g. blood glucose, serum lipids, etc.) were examined before and 1-, 2- and 3- years after treatment in the both groups. MCA peak systolic blood flow velocity, pulsatility index (PI), resistance index (RI) and spectrum contour were recorded in TCD. Results TCD indexes showed no statistical difference at 1st year after treatment (P > 0.05), but all the findings improved at 2 and 3 years later including significant improvement of spectrum contour in the intervention group (P < 0.01). At the end of follow-up period, compared to the former indexes before treatment the differences of MCA indexes between both groups were significant (P < 0.01, for all) and the incidence of cerebrovascular events in intervention group (10/90, 11.11%) was significantly lower than that in control group (21/87, 24.14%) (P < 0.01). Conclusion When blood pressure decreased effectively, long-term treatment with both simvastatin and aspirin could stabilize and delay the progression of MCA stenosis and reduce cerebrovascular events incidence in hypertension patients.更多还原