辛伐他汀对原发性高血压并高胆固醇血症患者血管内皮依赖性舒张功能的影响  

Cholesterol-lowing therapy with simvastatin in the hypertensive patients with hypercholesterolemia improves vascular endothelium-dependent relaxation

作　　者：莫新玲[1] 赵水平[2] 唐建华[1] 阳耀忠[1] 

机构地区：[1]桂林医学院附属医院心内科,广西桂林541001 [2]中南大学湘雅第二医院心内科

出　　处：《临床心血管病杂志》2003年第10期591-593,共3页Journal of Clinical Cardiology

基　　金：广西壮族自治区教育厅课题 (No .14 )

摘　　要：目的 :研究辛伐他汀对原发性高血压 (EH)并高胆固醇血症患者血管内皮依赖性舒张功能的影响。方法 :采用高分辨超声技术 ,对 2 4例EH并高胆固醇血症患者 (A组 )降脂前后和 2 0例血浆胆固醇水平正常的对照者 (B组 )血管内皮依赖性舒张功能进行检测。结果 :A组患者服用辛伐他汀 10mg治疗 8周后肱动脉血流介导性舒张较B组明显减弱 [(2 .99± 2 .2 4 ) %∶(7.0 1± 2 .73) % ,P <0 .0 1],且对硝酸甘油的反应差异亦有显著性意义[(8.2 8± 5 .12 ) %∶(12 .2 8± 4 .84 ) % ,P <0 .0 5 ]。血浆总胆固醇从 (6 .39± 0 .71)mmol L降至 (5 .2 3± 0 .33)mmol L ,同时肱动脉内皮依赖性舒张较治疗前明显改善 [(7.82± 1.2 9) %∶(2 .99± 2 .2 4 ) % ,P <0 .0 1],而治疗前后肱动脉对硝酸甘油的反应无显著性改变。结论 :EH并高胆固醇血症患者存在血管内皮依赖性舒张功能障碍 ;经辛伐他汀降胆固醇治疗后 。Objective:To investigate the effect of simvastatin on endothelium dependent dilational function in the hypertensive patients with hypercholesterolemia.Methods:With high resolution ultrasound, we study endothelium dependent dilational function in 44 subjects: 20 with normal blood cholesterol and 24 primary hypertensive patients with hypercholesterolemia.Results:In the hypertensive patients with hypercholesterolemia, flow mediated dilatation in arteries was more reduced compared with control group ( 2.99 ± 2.24 )% vs ( 7.01 ± 2.73 )%, P< 0.01 , and there was significant difference in reaction to nitroglycerin between these groups ( 8.28 ± 5.12 )% vs ( 12.28 ± 4.84 )%, P< 0.05 . Twenty four patients with hypertension and hypercholesterolemic were received cholesterol lowing therapy with simvastatin for 8 week, by which serum cholesterol reduced ( 6.39 ± 0.71 ) mmol/L to ( 5.23 ± 0.33 ) mmol/L (P< 0.01 ). Flow mediated vasodilations improved significantly after simvastatin therapy ( 7.82 ± 1.29 )% vs ( 2.99 ± 2.24 )%, P< 0.001 ). The vasodilation response to nitroglycerin had no significant change after cholesterol lowing therapy.Conclusion:Endothelium dependent vasodilation was impaired in the hypertensive patients with hypercholesterolemia, and cholesterol lowing therapy with simvastatin may improve impaired endothelium dependent vasodilation.

关 键 词：高血压 高胆固醇过多症 辛伐他汀 内皮 血管 

分 类 号：R544.1[医药卫生—心血管疾病] R389.2[医药卫生—内科学]