3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂对老年原发性高血压患者血管内皮功能的影响

目的探讨3-羟基-3-甲基戊二酰辅酶A(HMG-CoA)还原酶抑制剂对老年原发性高血压患者血管内皮功能的影响.方法采用随机对照方法,观察66例老年原发性高血压患者(治疗组)经普伐他汀(pravastatin)10mg每日1次治疗12周后血浆内皮素(ET)、一氧化氮(NO)水平的变化,并与40例安慰剂组和15例正常血压组对照.结果治疗组和安慰剂组患者血浆ET水平明显高于正常血压组,血浆NO水平则较正常血压组显著降低.治疗组血浆ET水平治疗后较治疗前平均降低26.7%,有显著性差异(P＜0.05),而NO水平比治疗前平均上升248.3%,有非常显著性差异(P＜0.001);不同低密度脂蛋白胆固醇(LDL-C)水平的原发性高血压患者治疗后血浆ET和NO水平的变化无显著性差异(P＞0.05).结论提示普伐他汀可能具有改善老年原发性高血压患者血浆ET和NO异常,保护血管内皮功能的作用,且其对ET和NO的影响与LDL-C水平无关.

Effect of 3-Hydroxy-3-Methylglutaryl-CoA Reductase Inhibitors, Pravastatin, on theFunction of Vascular Endothelium in Gerontal Hypertension

Objective: To investigate the effect of 3- hydroxy-3-methylglutaryl-CoA (HMG -CoA ) reductase inhibitor, pravastatin, on the function of vascular endothelium in gerontal hypertensive patients through the changed concentrations of plasma endotheiln (ET)and nitric oxide (NO)before and after treatment. Methods: One hundred and six cases of essential hypertension aged 65 or older were randomly divided into two groups. Sixty-six patients were treated with pravastatin for 12 weeks, and 40 were the controls.Plasma ET and NO were mea- sured before and after treatment in both groups. Results: Concentration of plasma ET was significantly higher in gerontal hypertensives than in gerontal normotensives, but plasma NO was significantly lower. In the treatment group, pravastatin resulted in a significant reduction in plasma ET and a rise in NO (26.7%, p<0 .05 and 248.3%, p<0.001 respectively)that were not correlated with the change of low density lipoprotein (LDL-C) level in hypertensive patients (p>0.05). Conclusion: Treatment with pravastatin(one of the HMG-CoA reductase inhibitors)can produce a protective effect on the function of vascular endothelium in gerontal hypertensives.