辛伐他汀对高血压病患者左室重量和血管内皮功能的影响及其间的关系  

Effects of simvastatin on left ventricular mass and endothelial function in essential hypertension.

作　　者：张平洋[1] 冯雪虹[1] 王沛[1] 王冲[1] 邓又斌[2] 杨好意[2] 

机构地区：[1]南京医科大学附属南京第一医院心血管超声科,江苏南京210001 [2]华中科技大学同济医学院附属同济医院超声影像科,湖北武汉430030

出　　处：《四川医学》2010年第9期1364-1366,共3页Sichuan Medical Journal

摘　　要：目的探讨辛伐他汀对高血压病(EH)患者左室重量(LVM)和内皮功能的影响及其间的关系。方法 76例EH患者被随机分为各3 8例的Ⅰ(口服辛伐他汀和利尿剂)、Ⅱ组(口服利尿剂),超声研究受检者治疗12周前后左室重量指数(LVMI)并结合高频超声观察肱动脉内皮依赖性扩张(DIRH)及非内皮依赖性扩张功能(DING)。30例正常人作为对照组。结果治疗前Ⅰ、Ⅱ两组患者的LVMI(142.02±30.79)、(138.23±32.19)g/m2较正常对照组(82.48±25.24)g/m2增大(P<0.0001),血压增高,而DIRH(5.63±2.15)%、(6.15±2.58)%较对照组(13.19±2.72)%显著减小(P<0.0001),DING、年龄、血脂、血糖差异无统计学意义。Ⅰ、Ⅱ两组参数间差异无统计学意义(P>0.05)。治疗后Ⅰ组患者的LVMI减小(142.02±30.79)g/m2VS(87.23±16.26)g/m2(P<0.0001),DIRH增大(5.63±2.15)%VS(12.86±2.48)%(P<0.0001),而Ⅱ组LVMI、DIRH无显著性改变;两组患者的血压下降至正常。Ⅰ、Ⅱ两组相比,前者的左室重量指数变化率(LVMICH)、DIRH及其变化率(DIRHCH)较后者显著增大(P<0.05);血压、血糖、血脂差异无统计学意义。治疗前后血脂、血糖无显著变化。相关分析表明:患者治疗前的LVMI与DIRH之间、LVMICH与DIRHCH间均呈良好相关性(r=-0.59;0.7 1,P<0.0001)。结论高血压病患者左室重量增加与内皮功能障碍相关,辛发他汀可以抑制患者左室重量增加并同时显著改善内皮功能。Objective To investigate the effect of simvastatin on the left ventricular mass and endothelial function and to study the relationship between them.Methods 76 patients with hypertension without severe complication were divided into two groups in a randomized,controlled and single blind trial.Group I（n=38） were given simvastatin and hydragogue for 12 weeks while Group Ⅱ（n=38） were given hydragogue during the same time.We detected the left ventricular mass and the brachial artery dilatation induced by reactive hyperemia or nitroglycerin respectively with ultrasorrography in all patients before and after treatment.30 normal subjects without any treatment were taken as the control.Results Compared with the control（g/m2）：（82.48±25.24）,the left ventricular mass index（LVMI）was higher in the two groups of patients before treatment（142.02±30.79）、（138.23±32.19）g/m2（P0.0001） while the blood pressure was higher.The brachial artery dilatation induced by reactive hyperemia was lower（5.63±2.15）%、（6.15±2.58）%than the normal（13.19±2.72）%（P0.0001）.There was no significantly difference in age,serum concentrations of total cholesterol or triglyceride or sugar,blood pressure and the brachial artery dilatation induced by nitroglycerin（DING） between two groups of patients and the control（P0.05）.And there was no significant difference in the all variables between group I and group Ⅱ.After treatment the LVMI decreased（142.02±30.9）g/m2 VS（87.23±16.26）g/m2（P0.0001） and the DIRH increased（5.63±2.15）% VS（12.86±2.48）%（P0.0001） to the normal level in the patients of group I while there was no significant change in LVMI and DIRH in the patients of group Ⅱ.The blood pressure in the two groups of patients was decreased to the normal.Compared with group Ⅱ,the changes of LVMI and DIRH was higher in patients of group I though the serum concentrations of total cholesterol,triglyceride or sugar were not significantly different.And there was no signi

关 键 词：高血压病 辛伐他汀 左室重量 内皮功能 

分 类 号：R544.1[医药卫生—心血管疾病]