阿托伐他汀对原发性高血压过氧化损伤及心肌纤维化的影响

Effects of atorvastatin on lipid peroxidation and cardiac fibrosis in patients with essential hypertension

目的:观察阿托伐他汀对原发性高血压(EH)过氧化损伤及心肌纤维化的影响。方法:将59例EH患者随机分为阿托伐他汀组(30例)和对照组(29例)。两组均以贝那普利(10mg/d)和螺内酯(20mg/d)控制血压。阿托伐他汀组加用阿托伐他汀20mg/d。测定治疗前后血清一氧化氮(NO)、超氧化物歧化酶(SOD)、丙二醛(MDA)及Ⅲ型前胶原末端肽(PⅢP)、Ⅳ型前胶原末端肽(PⅣP)水平,同时观察左室结构及舒缩功能变化。结果:治疗12周后,两组患者平均动脉压、MDA、PⅢP、PⅣP及左室质量指数(LVMI)较治疗前均有降低(P<0.05或P<0.01),且以阿托伐他汀组降低更明显,与对照组比较差异有统计学意义(P<0.05或P<0.01);NO、SOD水平及左室舒张功能较治疗前均有明显改善,也以阿托伐他汀组改善更显著(P<0.05或P<0.01)。NO、SOD和MDA与PⅢP水平存在显著的相关性。结论:EH患者在接受常规降压治疗的同时,加用阿托伐他汀可更好地控制血压,显著减轻过氧化损伤和心肌纤维化,改善心脏功能。

Objective:To investigate effects of atorvastatin on lipid peroxidation and cardiac fibrosis in essential hypertension(EH).Method:The 59 patients with EH on the basis of benazepril and spironolatone treatment were randomly assigned to receive atorvastatin(20 mg/d, n=30) or placebo (n=29). Serum concentrations of NO, SOD, MDA, PⅢP, PⅣP were measured and doppler ultrasound recording were obtained to determine several parameters relating to the left ventricaular anatomy and function before and after treatment.Result:Through 12 week's treatment, patient's mean blood pressure(MBP), MDA, PⅢP, PⅣP, LVMI in two groups were significantly decreased (P< 0.05 or P< 0.01), especially in atorvastatin group. NO, SOD, E/A were significantly increased in two groups after treatment, but the changes in the atorvastatin group were more significant than those in the control group(P< 0.05 or P< 0.01). A significant correlation existed between NO, SOD and MDA with PⅢP.Conclusion:Applying atorvastatin in EH patients on the basis of benazepril and sprionolactone treatment, can reduce blood pressure, inhibit lipid peroxidation, and prevent cardiac fibrosis and improve heart function.