血脂康对高血压患者心脏舒张功能的影响

目的探讨他汀类药物是否能够改善高血压病患者的心脏舒张功能。方法对100例血脂正常或轻度升高的高血压患者采用随机、单盲、安慰剂对照研究。分别给予血脂康或安慰剂治疗24周,两组降压药物均选用尼非地平缓释片。于试验前、试验结束分别检测血浆Ⅰ型前胶原羧基端肽、应用脉冲组织多普勒测量及记录舒张早期及舒张晚期最大速度。结果血脂康治疗组较之安慰剂组血压达标率增加,脉压减小。血脂康治疗24周后Ⅰ型前胶原羧基端肽的血浆水平降低。血脂康组治疗24周后右房室环与右心室游离壁交界处、右房室环与室间隔交界处、二尖瓣前瓣瓣环与室间隔交界处的舒张早期及舒张晚期最大速度之比增加,但无统计学意义（P〉0．05）;同安慰剂组相比,用药24周后,血脂康组二尖瓣后叶瓣环与左室侧壁交界处舒张早期及舒张晚期最大速度之比增加（P〈0．05）。结论高血压患者加用血脂康可以使心肌纤维化的相关指标改善、血压降低、进而改善左室舒张功能。

The effect of Xuezhikang on ventricular diastolic function in hypertension

OBJECTIVE: To investigate whether statins have effect on diastolic function of both left and right ventricles in hypertensive patients. METHODS: This is a randomized, mono-blind, placebo-controlled study. 120 systemic hypertensive (HT) patients with normal or slightly elevated cholesterol were randomized to placebo or Xuezhikang (1200 mg/d) for 24 weeks. Extended-release nifedipine was administrated to the HT patients. 30 healthy volunteers served as controls. Plasma were obtained at baseline and 24 weeks after Xuezhikang therapy. Cholesterol and carboxy-terminal peptide of procollagen type I (PIP) were measured. Early diastolic velocity (Em) and late diastolic velocity (Am) were obtained from right atrioventricular ring and left atrioventricular ring with pulsed wave tissue Doppler imaging. RESULTS: The levels of plasma PIP were higher in HT patients. After 24 weeks, the levels of plasma LDL-C, TC and PIP were significantly lower in Xuezhikang group than those in placebo group; Systolic and diastolic pressure were decreased both in placebo group and Xuezhikang group meanwhile pulse pressure was decreased and Em/Am ratio at left atrioventricular ring was higher in Xuezhikang group as compared with those in placebo group. CONCLUSION: In systemic hypertensive patients, Xuezhikang exerts a beneficial effect on diastolic function of left ventricule via controlling blood pressure, lowering blood lipid and inhibiting myocardial fibrosis.