阿托伐他汀对原发性高血压患者血脂及心功能的影响

目的观察阿托伐他汀对原发性高血压患者血脂以及心功能的影响。方法 1级或2级原发性高血压患者118例,随机单盲分为2组:对照组59例,给予厄贝沙坦为基础的降压治疗;观察组59例,服用厄贝沙坦的同时加用阿托伐他汀20 mg口服,每晚1次。疗程均为24周。观察比较2组治疗前后血脂、心功能的变化。结果 2组治疗前血脂及血浆BNP水平比较差异无统计学意义(P>0.05);对照组治疗前后TC、LDL-C、HDL-C、TG变化无统计学意义(P>0.05);观察组治疗后TC、LDL-C降低,且低于对照组,差异有统计学意义(P<0.05),而TG、HDL-C无显著变化(P>0.05)。治疗组治疗后BNP水平下降,低于治疗前和对照组治疗后(P<0.05);2组治疗前后对比LVEF无显著变化(P>0.05);治疗24周后,对照组患者的IVST、LVM、LVMI以及LA均较前下降(P<0.05),而LVDd、LVSd、LVPWT、E/A比值均无显著变化(P>0.05);治疗组患者的IVST、LVPWT、LVM、LVMI均较前下降,LVDd、LVSd均减小,E/A比值升高,差异均具有统计学意义(P<0.05)。2组治疗后比较,除LVEF外,治疗组各项指标均优于对照组(P<0.05)。结论 (1)轻中度原发性高血压患者联用厄贝沙坦和阿托伐他汀能显著降低TC、LDL-C及BNP水平,减轻房室压力、逆转房室扩大及心室肥厚,显著改善左室舒张功能;(2)阿托伐他汀对轻中度原发性高血压患者的左室收缩功能可能没有作用。

The effect of atorvastatin on the blood lipid and ventricular function in essential hypertension patients

Objective To investigate the effect of atorvastatin on the blood lipid and left ventricular function in essen- tial hypertension patients. Methods Totally 118 essential hypertension patients with grade 1 or 2 were enrolled. These pa- tients were randomly divided into two groups after 4 week blood pressure control with irbesartan. Patients in group A as control group （ n = 59） continued the same treatment, and patients in group B as experimental group （ n = 59 ） were treated with atorvastatin 20 rag/day based on the original treatment. This trial continued for 24 weeks. The levels of blood lipid and the variation of left ventricular function by ultrasonic cardiogram in the two groups were compared before and after 24 week treat- ment. Results There was no statistical significance to compare the levels of blood lipid in group A and group B pre treatment （ P 〉 0.05 ） ; The changes of the levels of TC, LDL-C, HDL-C and TG were showed no statistical significance pre and post treatment in control group （ P 〉 0.05 ） , while the changes in group B had significance difference （ P 〈 0.05 ） ; After the treatment, the levels of TC and LDL-C in group B were significantly lower than those of group A, thus there was statistical sig- nificance （ P 〈 0.05 ）, but there was no obvious changes in TG and HDL-C （ P 〉 0.05 ）. There was no significant changes in LVEF before and after the 24-week treatment in both groups （ P 〉 0.05 ）. The indexes Of IVST, LVM, LVMI, and LA were reduced in group A after the treatment （ P 〈 0.05 ）, but there was no obvious change in LVDd, LVSd, LVPWT and E/A ratio（ P 〉 0.05 ） ; The IVST, LVPWT, LVM, LVMI were reduced and E/A ratio increased in group B after the treatment （ P 〈 0.05）. Compard the two groups after treatment, there were significant differences except LVEF （ P 〈 0.05）. Conclu- sion （ 1 ） For patients with mild or moderate essential hypertension, treatment with irbesartan and atorvastatin could not only reduce the blood lipids level, but also alleviate the atrium and ventricle pressure, reverse the atrium and ventricle enlargement and ventricular hypertrophy, and could also improve left ventricular diastolic function significantly. （2）Atorvastatin may have no effects on left ventricular systolic function for patients with mild or mediator essential hypertension.