原发性高血压患者血管内皮功能变化与普伐他汀的影响

Effect of pravastatin on vascular endothelial function in patients with essential hypertension

目的:观察普伐他汀对原发性高血压患者血管内皮功能的影响。方法:①试验分组:选择2005-01/2006-10辽宁医学院附属第一医院心内科住院及门诊原发性高血压患者100例,随机分为普伐他汀组(n=52),常规治疗组(n=48)。高血压诊断标准按1999WHO/ISH确定诊断标准,收缩压≥140mmHg和(或)舒张压≥90mmHg,排除继发性高血压及心、肝、肾、脑、糖尿病等器质性族病,另选50名正常人作为对照组,均经询问病史、体格检查、X线、心电图检查正常者。所有受试者知情同意。②试验方法:常规治疗组主要应用β-受体阻滞剂、钙拮抗剂、利尿剂等药治疗8周。普伐他汀组在常规治疗组基础上加用普伐他汀40mg,1次/d,共用8周。③试验评估:比较普伐他汀组及常规治疗组治疗前后血压的变化及血浆内皮素、一氧化氮和丙二醛的含量。结果:纳入原发性高血压患者100例及正常人50名,均进入结果分析。①普伐他汀组与常规治疗组治疗前后收缩压、舒张压间差异存在显著性(P<0.01),两组间比较差异无显著性(P>0.05)。②普伐他汀组及常规治疗组内皮素、丙二醛含量均高于对照组,一氧化氮低于对照组,差异有显著性意义(P<0.01);治疗后普伐他汀组内皮素、丙二醛含量较治疗前及常规治疗组降低,差异显著(P<0.01),一氧化氮治疗后较治疗前及常规治疗组升高,差异有显著性意义(P<0.01)。结论:原发性高血压患者存在内皮功能损害,普伐他汀具有改善内皮功能的作用。

AIM： To investigate the effect of pravastatin on the function of vascular endothelium in essential hypertensive patients. METHODS： ①100 essential hypertensive in and outpatients were selected from Department of Cardiology, First Affiliated Hospital of Liaoning Medical University between January 2005 and October 2006, and randomly divided into pravastatin group （n =52）, and routine treatment group （n =48）. Hypertension was diagnosed according to the 1999 world health organization-international society of hypertension guidelines for the management of hypertension： systolic pressure （SP） ≥140 mm Hg and （or） diastolic pressure （DP） 1〉 90 mm Hg. Those with secondary hypertension, and heart, liver, lung, brain, diabetes and other organ diseases were excluded. Meanwhile, another 50 normal people were selected as control group, who were regarded as normal through the history of illness, physical examination, X-ray, and electrocardiography. All the subjects were informed and agreed to the experiment. ②The patients in routine treatment group were treated by 13-receptor blocker, calcium channel blocker, diuretic and so on for 8 weeks; patients in pravastatin group were treated with 40 mg pravastatin once daily for 8 weeks besides on the routine therapy.③Changes in blood pressure, and content of plasma endothelin （ET）, nitric oxide （NO） and malondialdehyde （MDA） in pravastatin group and routine treatment group were compared. RESULTS： 100 hypertensive patients and 50 normal people were all involved in the result analysis. ①There were significant differences in DP and SP before and after treatment in both pravastat in group and routine treatment group （P 〈 0.01）, but no difference between these groups （P 〉 0.05）. ②The levels of ET and MDA in pravastatin and routine treatment groups were remarkably higher than control group, but NO was lower than control group （P 〈 0.01）; after treatment, the levels of ET and MDA were significantly decreased, but NO was increased markedly in pravastatin group compared with that before treatment and routine treatment group （P 〈 0.01）. CONCUSION： The function of vascular endothelium is damaged in patients with essential hypertension. Treatment with pravastatin can improve the function of vascular endothelium.