阿托伐他汀增加高血压患者外周血内皮祖细胞数量

Atorvastatin on Circulating Endothelial Progenitor Cells and Blood Pressure in Hypertensive Patients

目的观察阿托伐他汀对无脂代谢紊乱的高血压患者外周血内皮祖细胞(EPCs)数量及血压的影响。方法原发性高血压患者38例随机分为单用常规降压药物组(常规组,n=18)和常规降压药物与阿托伐他汀(20mg 睡前)联合用药组(联合组,n=20)。8例健康志愿者口服阿托伐他汀8周作为对照组(n=8)。于治疗前和治疗后8周分别测血压并抽取外周血进行 EPCs 的分离培养,第10天对 EPCs 进行鉴定并于倒置相差显微镜下计数内皮祖细胞克隆形成单位(EPC-CFU)以评估外周血 EPCs 水平。结果 1)常规组和联合组治疗前后收缩压均有显著下降,分别为(165.8±10.3)vs(132.7±10.3)mmHg 和(163.7±10.2)vs(127.9±10.1)mmHg;加用阿托伐他汀血压下降幅度较单用降压药大[(35.7±3.4)vs(33.1±2.4)mmHg,P<0.05]。对照组服药前后收缩压的差异无统计学意义(114.2±18.4)vs(108.4±21.6)mmHg。2)常规降压药8周后 EPC-CFU 从(8.8±2.0)升为(12.1±2.2);联合用药后 EPC-CFU 从(9.2±1.9)升为(13.6±2.2)个。两组 EPC-CFU 改变值[(3.3±0.6)vs(4.5±1.1)]的差异有统计学意义(P<0.05)。对照组服药前后 EPC-CFU 为(13.2±2.8)vs(16.2±3.5)。3)联合组治疗前后血压下降幅度与 EPC-CFU 改变值呈正相关(r=0.581,P=0.007)。结论高血压可减少外周血 EPCs 数量,在应用常规降压药物基础上加用阿托伐他汀可增加外周血 EPCs 数量并进一步降低血压。

Objective To investigate the effect of atorvastatin on circulating endothelial progenitor cells （EPCs） and BP in hypertensive patients with normal lipid profiles. Methods Thirty-eight hypertensive patients were randomly to receive conventional anti-hypertensive drugs （n= 18） or conventional anti-hypertensive drugs plus atorvastatin（20 mg QN）combination treatment （n=20）. Eight healthy subjects were given atorvastatin （20 mg QN） for 8 weeks as control group. Before and after treatment, peripheral blood were drawn to isolate and culture EPCs. The circulating EPCs were identified by direct fluorescent staining under a laser scanning confocal microscope. EPCs populations were assessed using the colony forming unit assay （EPC-CFU） through a inverted phase contrast microscope 10 days after culture. Results After treatment, SBP was decreased （conventional treatment from 165.8± 10. 3 to 132. 7 ± 10. 3 mmHg; combined group from 163.7 ± 10. 2 to 127.9 ± 10. 1 mmHg P〈 0. 05） with no effect on BP by atorvastatin alone. Anti hypertension treatment increased the EPC-CFU levels in both conventional and combined groups （conventional ： 8. 8 ±2.0 to 12.1±2.2 ; combined group： 9. 2 ± 1.9 to 13.6 ± 2. 2）, with significant intergroups significance （P〈0. 05）. The magnitude of increases in EPC-CFU in combined group correlated with its SBP change （r=0. 581, P= 0. 007）. Conclusion The peripheral blood EPCs populations was decreased in patients with hypertension. Atorvastatin therapy on the basis of conventional anti-hypertensive drugs treatment increase the Peripheral blood EPCs population and decrease SBP.