辛伐他汀对隐匿性高血压患者内皮功能的影响

目的 探讨辛伐他汀对隐匿性高血压患者血管内皮功能的影响.方法 根据动态血压和诊室偶测血压将研究对象分为隐匿性高血压组（MH组,35例）和正常血压组（NT组,30例）.所有入选者均测定血清非对称性二甲基精氨酸（AMDA）、可溶性血管细胞间黏附分子-1（sVCAM-1）及主要的血清生化指标,并通过彩色多普勒超声测定颈动脉内膜中层厚度（IMT）.MH组给予辛伐他汀20 mg/晚,共8周,然后再复查上述指标.结果 MH组血清ADMA、sVCAM-1和颈动脉IMT均显著高于NT组（P＜0.01）;MH组治疗前后比较,血清ADMA和sVCAM-1显著下降（P＝0.024,P＝0.038）,而颈动脉IMT减少无统计学意义（P＝0.08）.直线相关分析显示,MH组治疗前的血清ADMA（r＝0.68,P＜0.01）、sVCAM-1（r＝0.63,P＜0.01）与颈动脉IMT具有直线正相关.结论 MH患者存在血管内皮功能障碍和颈动脉硬化,辛伐他汀可以改善MH患者血管内皮功能.

Effects of simvastatin on endothelial function in patients with masked hypertension

Objective To study the effects of Simvastatin on endothelial function in patients with masked hypertension. Methods All subjects were classified into masked hypertension group （group MH, n=35） and normotension group （group NT, n=30）. All patients in group MH were prescribed 20 rag/day of Simvastatin. Serum asymmetric dimethylarginine （ADMA）, soluble vascular cell adhesion molecule-1 （sVCAM-1 ）, biochemical parameters and carotid intima-media thickness （IMT） were measured at baseline in all subjects and aider 8 weeks of treatment in group MH. Results Serum ADMA（3.34±0.88） vs （2.73±0.52） umol/L, serum sVCAM-1（872.9± 197.5） vs （781.1±162.6） ng/ml, and carotid IMT （0.95±0.21） vs （0.81±0.11）mm were singnificantly higher in group MH than those in group NT （P〈0.01, respectively）. After treatment in group MH, the levels of serum AD- MA[（3.34±0.88） vs （2.87±0.85） umol/L, P=0.024] and sVCAM-1[（872.9±197.5） vs （781.1±162.6）ng/ml, P=0.038] were singnificantly decreased, but no significant difference existed in carotid IMT（P=0.08）. Serum ADMA and sVCAM-1 were positively related with carotid IMT in group MH （r=0.68, P〈0.01, and r=0.63, P〈 0.01 ）. Conclusion Endothelial dysfunction and carotid atherosclerosis were existed in MH patients, and Simvastatin could improve endothelial function in these patients.