长期血脂康治疗对高血压患者的心脏保护作用

目的 探讨长期血脂康治疗对高血压患者心脏的保护作用.方法 采用随机、双盲、安慰剂对照研究.60例血脂正常的原发性高血压患者,分别给予血脂康+尼非地平或安慰剂+尼非地平治疗72周.超声心动测量室壁厚度、左心室内径,二尖瓣口舒张早期与舒张晚期最大流速,房室环与室壁交界处局部心肌舒张早期及舒张晚期最大速度等;检测血浆Ⅰ型胶原羧基端前肽.结果 同治疗前及安慰剂组相比,血脂康治疗72周后,右房室环与室间隔交界处、二尖辩前瓣瓣环分别与室间隔、左心室侧壁交界处的舒张早期及舒张晚期最大速度之比、二尖瓣口舒张早期与舒张晚期最大流速之比均增加,差异均有统计学意义(P<0.01,P<0.05);同治疗前及安慰剂组相比,血脂康组治疗24周后Ⅰ型胶原羧基端前肽降低,差异有统计学意义(P<0.01,P<0.05).结论 原发性高血压患者长期应用血脂康可以使心肌纤维化的相关指标改善而保护心脏功能.

Protection effects of Xuezhikang on heart in hypertension patients.

Objective To investigate the effect of xuezhikang on heart in patients with hypertension. Meth-ods 60 systemic hypertension (HT) patients with normal cholesterol were randomized into placebo group and Xu-ezhikang group (1200 mg/d) for 72 weeks. Extended-released nifedipine were administrated by HT patients. Plasma was obtained at baseline, after 24 weeks and 72 weeks of Xuezhikang therapy. Em/Am ratio at atrioventricular ring , E/A ratio at mitral orifice, IVSTd, LVIDd, LVPWTd were measured by echocardiography. Type Ⅰ collagen car-boxypropeptide (PIP) was determined. Results After 72 weeks treatment, the differences of LVWT, IVSTd, LVP-WTd and LVIDd between Xuezhikang group and the control group were not significant; E/A,Em/Am ratios at atrio-ventricoiar ring were significantly increased except that Em/Am at right atrioventricular ring with right ventricular lateral wall(P <0.01 ,P <0.05). After 24 weeks treatment the levels of plasma PIP were significantly decreased in Xuezhikang group compared with the placebo group (P < 0.01, P < 0.05). Conclusion Xuezhikang exerts cooper-ativity in improving those parameters related to myocardial fibrosis so to protect heart function of hypertension pa-tients.