阿托伐他汀对不同血脂水平的高血压病患者血管内皮功能的影响  

Effect of Atorvastatin on Vascular Endothelial Function in Essential Hypertension with Normocholesterol- emia and Hypercholesterolemia

作　　者：陈月云[1] 章辉[2] 朱正才[1] 王德国[1] 张平洋[3] 

机构地区：[1]干部病房内科 院弋矶山医院,安徽芜湖241000 [2]急诊内科 院弋矶山医院,安徽芜湖241000 [3]影像学科 皖南医学院弋矶山医院,安徽芜湖241000

出　　处：《高血压杂志》2005年第2期88-92,共5页Chinese Journal of Hypertension

摘　　要：目的研究阿托伐他汀对正常血脂和高血脂的高血压病(EH)患者血管内皮功能的影响。方法采用双盲、随机、对照方法,将正常血脂(NC组)和高血脂(HC组)高血压病患者分为他汀治疗组(阿托伐他汀20mg／d,共8周,NC组,n=22;HC组,n=24)和未用药对照组(NC组,n=21;HC组,n=24);运用无创超声检查技术,观察用药前后颈动脉内一中膜厚度(IMT)及肱动脉内皮依赖性舒张功能(FMD)的变化,同时检测血清一氧化氮(NO)及内皮素-1(ET-1)的浓度水平。结果治疗前NC、HC各组IMT值和血清ET-1水平较健康对照组(n=40)明显升高(P<0.01),FMD值和NO水平却显著下降(P<0.01),IMT、FMD、NO与LDL-C存在着显著的相关性。治疗8周后,NC、HC各组IMT值和ET-1水平明显降低,FMD和NO水平显著上升。与对照组比较,他汀治疗组的IMT、ET-1降低更明显(P<0.05),FMD和NO升高更为显著(P<0.05)。两他汀治疗组的血脂水平较治疗前均明显下降(P<0.05,P<0.01)。结论阿托伐他汀治疗正常血脂和高血脂的高血压病患者,可在有效调脂的同时,发挥其非调脂作用,逆转或延迟颈动脉IMT的进程,改善血管内皮功能。Objective To investigate the effect of atorvastatin on vascular endothelial function in patients of essential hypertension (EH) with hypercholesterolemia (HC) or without (NC) . Methods Forty-three NC and forty-eight HC patients of EH were randomized, double-blind, and assigned to atorvastatin (20 mg/d, NC group, n = 22, HC group, 77 =24) or to the control group (no lipid-lower-ing drugs, NC group, n = 21, HC group, n = 24) for 8 weeks. Changes in carotid arterial intima-media thickness (IMT) and brachial arterial endothelium dependent diastolic function (FMD) before and after treatment were investigated by ultrasound. Levels of serum nitric oxide (NO) and endothe-lin-1 (ET-1) were determined. Results The patients with EH in both NC group and HC group had higher of ET-1, IMT, lower NO and FMD compared with those of healthy group (P<0. 01,n = 40). After treatment of atorvastatin, IMT, ET-1 in NC and HC groups were significantly decreased (P <0. 05, P<0. 01) , associated with increased FMD and NO (P<0. 05, P<0. 01). Statin treatment significantly reduced the levels of blood lipid in HC and NC group (P<0. 05, P<0. 01 ). IMT, FMD, NO were markedly correlated with LDL-C. Conclusion Atorvastatin substantially improves the vascular endothelial function and prevent the carotid arteriosclerosis in EH patients irrespective of their serum cholesterol level.

关 键 词：IMT 高血压病 阿托伐他汀 患者 血管内皮功能 ET-1 血脂水平 结论 上升 方法 

分 类 号：R544.1[医药卫生—心血管疾病] R541.4[医药卫生—内科学]