The Study Of Lipid-lowing Therapy With Combined Traditional Chinese And Western Medicine On Renal Atherosclerosis Hypertension

Part 1 Clinical AnalysisObjective: The purpose was to help early diagnosis and intervention of patients with atherosclerosis renal artery stenosis(ARAS)by retrospective analysis of pathogenesis and risk factors of ARAS.Methods: The 245 patients who came to one hospital of Changchun and received the renal ateriography or kidney arterial CTA were retrospective analyzed of their age,sex,lipid,coronary atherosclerotic heart disease,hypertension,diabetes,cerebral infarction,renal function.Results: There were significant differences in age,the history of hypertension,cerebral infarction,coronary heart disease,2 branch lesions,3 branch lesions,left main lesion,smoking,dyslipidemia,creatinine and glomerular filtration rate between the 50 patients with ARAS and the 195 patients who didn’t have renal artery stenosis.We analyzed the factors mentioned above using Logistic analysis,age(>60 years old),3 branch lesions,left main lesion,smoking,dyslipidemia,renal insufficiency were the risk factors of ARAS.Conclusions: Age(>60 years old),hypertension,3 branch lesions,left main lesion,smoking,dyslipidemia,renal insufficiency were risk factors of ARAS.Patients with any risk factor should pay more attention to the possibility of suffering from ARAS.Part 2 Experimental ResearchObjective: To observe and compare the therapeutic effects of different lipid-lowering projects and appraise the preferred project in ARAS rat model.Methods: 1.We established the rat model by narrowing the renal artery with acupuncture needle,and only exposed the renal artery in the sham operation group(F group).The operation group was divided into standard fed group(N group)and high fat fed group(T group),then the ARAS rat model were established after 8 weeks in T group.2.According to the different lipid-lowing therapeutic schedules,the T group rats were randomly divided into five groups: the blank group(T0 group),the Xuezhikang group(T1 group),the rosuvastatin group(T2 group),the regular dose of rosuvastatin combined with Xuezhikang(T3 group),the low dose of rosuvastatin combined with Xuezhikang(T4 group).After drug intervention for 6 weeks,we measured the variation of lipid(TC,TG,HDL-C,LDL-C),liver function(ALT,AST),renal function(BUN,Scr),atherosclerosis related factors(NO,ET-1,MPO,MMP-9),and observed the pathology of aorta,kidney and liver.Results: 1.Compared with F group,blood pressure,BUN and Scr were significantly increased in operation groups(P<0.05),which indicated that the renal artery stenosis rat model was successfully established.Compared with N group,TC,TG,LDL-C,ET-1,MPO,MMP-9 were significantly increased(P<0.05)and HDL-V,NO were significantly decreased(P<0.05)in T group.There was no difference in liver function between N group and T group(P>0.05).According to the pathological section,the aorta had visible atherosclerosis change,the renal tubules were atrophied and decreased,and the liver was full of fat cavitation in T group.All above,we concluded that the rat model of ARAS was successfully established.2.After 6 weeks of drug intervention,the blood pressure was slightly decreased in all treatment groups(P>0.05).Compared with prior treatment,TC,TG,LDL-C,BUN and Scr were significant decrease(P<0.05),while HDL-C was significantly increased(P<0.05)in all treatment groups,and the most remarkable change was in T3、T4 group,T3 group was better than T4 group with no significant difference between T3 and T4 group(P>0.05).We found that ALT and AST were significantly increased in T2 and T3 group(P<0.05).Compared with prior treatment,NO was significantly decreased(P<0.05)while ET-1,MPO,MMP-9 were significantly increased in T3 and T4 group,and the most remarkable change was in T3 group with no significant difference between T3 and T4 group(P>0.05).Compared with T0 group,pathological lesions of aorta,kidney and liver were reduced in all treatment groups,and T3 group was improved most remarkable with no obvious difference between T3 and T4 group.Moreover,necrosis of liver cells with inflammation infiltration was found in some rats of T2 and T3 group.Conclusions: 1.Low dose of rosuvastatin combined with Xuezhikang can achieve ideal lipid-lowing effects,protect renal function,and prevent lesion to the liver.2.Low dose of rosuvastatin combined with Xuezhikang can regular atherosclerosis related factors,control inflammatory response,and protect endothelial function to suppress the progression of disease.