瑞舒伐他汀联合硝苯地平的降压作用及其对血管内皮功能的影响

目的评价硝苯地平控释片联用瑞舒伐他汀对1级、2级原发性高血压患者血压及血管内皮功能的影响。方法采用随机单盲法将114例患者分为两组,对照组58例给予硝苯地平控释片30 mg、每日1次,联用组加用瑞舒伐他汀片10 mg、每日1次。另以50例正常血压者为正常组。12周后观察3组血压及血浆内皮素-1(ET-1)、一氧化氮(NO)水平的变化。结果两组患者的收缩压和舒张压均显著降低,但联用组较对照组血压下降更显著。联用组血浆ET-1水平治疗后较治疗前降低40.5%(P<0.01),较对照组治疗后降低28.6%(P<0.05);NO水平较治疗前升高81.0%(P<0.01),较对照组治疗后升高57.7%(P<0.01)。结论瑞舒伐他汀与硝苯地平控释片联用有明显的协同降压作用,并伴有血管内皮功能的改善,这可能是他汀类药物发挥协同降压作用的机制之一。

Synergic Hypotensive Effects of Rosuvastatin and Nifedipine Controlled Released Tablet and Their Influence on Vascular Endothelial Function

Objective To evaluate the effects of the combination of rosuvastatin and Nifedipine Controlled Released Tablet on the blood pressure and the vascular endothelial function in grade 1-2 essential hypertension. Methods By using the randomized, Single-blind, controlled method, 114 patients with essential hypertension were divided into two groups. The control group（58 cases） was given Nifedip-ine Controlled Released Tablet 30 mg, once daily, while the combination group（56 cases） was given Nifedipine Controlled Released Tablet 30 mg, once daily, and Rosuvastatin Tablet 10mg, once daily. Other 50 cases of normal blood pressure were taken as the control group. After 12 weeks, the changes of blood pressure, plasma endothelin-l（ET-1） and nitric oxide（NO） levels were observed in 3 groups. Results The systolic and diastolic blood pressures were significantly decreased in both groups, but the combination group was decreased more significantly than the control group. The plasma ET-1 level after treatment in the combinantion group was decreased by 40. 5% compared before treatment（ P 〈 0. 01） and by 28.6% compared with the control group（ P 〈 0. 05）; the NO level after treatment in the combination group was increased by 81.0% compared with before treatment and increased by 57.7% compared with the control group （P 〈 0. 01 ）. Conclusion The combination of rosuvastatin and Nifedipine Controlled Released Tablet has significant synergic hy-potensive effect complicating the improvement of vascular endothelial function, which may be one of mechanisms of statins drugs respon-sible for the synergic hypotensive effect.