阿托伐他汀对血脂正常原发性高血压患者血管内皮功能及血管活性物质的影响  

Effect of atorvastatin on endothelial function and vasoactive substances in essential hypertensive patients without hyperlipemia

作　　者：高瑜[1] 王丰[1] 张佩生[1] 梁雪[1] 

机构地区：[1]郑州大学第五附属医院心内二科,450052

出　　处：《中国综合临床》2011年第5期467-470,共4页Clinical Medicine of China

摘　　要：目的探讨阿托伐他汀对血脂正常的原发性高血压（EH）患者血管内皮依赖性舒张功能（FMD）及血管活性物质的影响。方法血脂正常的EH患者65例随机分为阿托伐他汀组33例，常规治疗组32例，另选取25名门诊健康体检者作为健康对照组。阿托伐他汀组在常规降压治疗基础上加入阿托伐他汀20mg，每晚1次口服。应用无创超声检查技术观察用药前后肱动脉血流介导的FMD的变化，同时检测一氧化氮（NO）、内皮素（ET-1）及血管性假性血友病因子（vWF）的含量变化。结果（1）治疗后阿托伐他汀组及常规治疗组FMD、NO水平均较治疗前明显上升，阿托伐他汀组与常规治疗组比较，FMD[（15．8±3．1）％与（8．7±2．5）％，t=4．048，P〈0．01]、NO[（49．9±5．6）μmol／L与（36．8±7．6）μmol／L，t=3．004，P〈0．01]显著高于常规治疗组。（2）治疗后阿托伐他汀组及常规治疗组ET-1及vwF均较治疗前明显降低，阿托伐他汀组与常规治疗组比较，ET-1[（43．5±13．7）ng／L与（52．5±14．7）ng／L，t=2．968，P〈0．01]、vWF[（124．7±28．5）％与（143．3±27．7）％，t=2．822，P〈0．01]显著低于常规治疗组。结论在血脂正常的EH患者中，阿托伐他汀可通过提高血浆NO浓度和降低ET-1、vwF浓度等非调脂机制改善血管内皮功能。Objective To investigate the effect of atorvastatin on vascular endothelial cell function and vasoactive substances in essential hypertensive patients without hyperlipemia. Methods Sixty-five essential hypertensive （EH） patients without hyperlipemia were enrolled and randomly divided into atorvastatin group and conventional treatment group （ oral taken atorvastatin or placebo once every night in addition of routine antihypertensive drugs）. Twenty five healthy subjects were also recruited as control. All cases were followed up for eight weeks. Serum cholesterol, nitric oxide （NO）, emdothelin-1 （ ET-1 ）, vonWillebrand-factor （vWF） levels were determined in each case. Flow-medizted dilation（FMD） was determined by high-resolution ultrasonography before and after eight weeks atorvastatin medication. Results （ 1 ） Before treatment, the FMD and NO levels of EH group were significantly lower than those of control group（P 〈 0. 01 ）, while the ET-1 and vWF levels of EH group were significantly higher than those of control group （ P 〈 0.01 ） ; （2） In EH patients, the FMD and NO levels significantly increased after treatment and increased even more dramatically in atorvastatin group, when compared to conventional treatment group （ Ps 〈 0. 01 ） ; （ 3 ） In EH patients, the ET-1 and vWF levels significantly decreased after treatment and decreased even more dramatically in atorvastatin group, when compared to conventional treatment group （ Ps 〈 0. 01）. Conclusion In patients of EH without hyperlipemia, atorvastatin can decrease plasma levels of ET-1, vWF, while increase plasma NO concentration and improve vascular endothelial function.

关 键 词：阿托伐他汀 原发性高血压 血脂 血管内皮功能 血管活性物质 

分 类 号：R544[医药卫生—心血管疾病]