氨氯地平对高血压患者左心室肥厚及高敏C反应蛋白的影响

Amlodipine to left ventricular hypertrophy and high-sensitivity C-reactive protein in patients with hypertension

目的探讨血清高敏C反应蛋白(hsCRP)与原发性高血压伴左心室肥厚(LVH)的相关性,并观察氨氯地平药物干预对血清hsCRP的影响。方法轻、中度高血压患者120例和健康对照组40例。高血压患者给予氨氯地平治疗6个月,对比血清hsCRP、左心室质量指数(LVMI)在治疗前后的变化。结果2级高血压组血清hsCRP高于1级高血压组,1级与2级高血压组均高于健康对照组,分别为(2.54±0.98)mg/L、(1.95±0.74)mg/L vs(1.08±0.73)mg/L(P<0.05或<0.01)。治疗前LVH组和高血压无左心室肥厚(NLVH)组血清hsCRP均显著高于健康对照组,LVH组又高于NLVH组,分别为(2.57±0.85)mg/L vs(1.94±0.89)mg/L vs(1.08±0.73)mg/L(均P<0.01),治疗后hsCRP均明显降低,但仍高于健康对照组(1.88±0.78)mg/L和(1.25±0.58)mg/L vs(1.08±0.73)mg/L(P<0.05或<0.01)。治疗前LVH组和NLVH组的LVMI均高于健康对照组146.71±22.60和116.31±12.42 vs 89.03±24.38(P<0.01);治疗后LVH组和NLVH组的LVMI均明显下降,但仍高于健康对照组119.32±12.34和111.81±11.21 vs 89.03±24.38(P<0.01)。血压与血清hsCRP呈正相关(r=0.203,P<0.05)。结论LVH组血清hsCRP与血压水平相关,提示炎症可能参与高血压的发生发展。氨氯地平不仅可以使血压平稳下降,还可逆转高血压伴左心室肥厚。

Objective To study the correlation between plasma high-sensitivity C-reaction protein（hsCRP） and essential hypertension with left ventricular hypertrophy （LVH）, to investigate amlodipine treatment to hsCRP influence. Methods 120 light,moderate patients with hypertension were selected,40 healthy subjects served as control group. The hypertensive patients were given long acting amlodipine for 6 months,then a comparison on the change of hsCRP and LVMI was studied between before and after treatment. Results Serum hsCRP in Grade 2 hypertension group was higher than Grade 1 ,and both of them were higher than that of control group, respectively （2.54 ± 0.98） mg/L,（1.95±0.74） mg/L vs （1.08±0.73） mg/L（ P 〈0.05 or P d0. 01）. Before treatment,serum hsCRP in the LVH group and the hypertension group with the non-LVH （NLVH） was significantly higher than that in control group,also the LVH group was higher than the NLVH group,respectively （2.57±0.85） mg/L vs （1.94±0.89） nag/ L vs （1. 08±0.73） rng/L （all P 〈0.01）. After treatment,serum hsCRP significantly dropped （ P 〈0.05） ,but it was higher than that of the control group, （1.88±0.78） mg/L and （1.25±0.58） mg/L vs （1.08±0.73） mg/L （P 0.05 or P 〈0.01）. Before the treatment, LVMI in the LVH and NLVH groups was higher than that of the control group, 146. 71± 22.60,116.31± 12.42 vs 89. 03± 24.38 （ P 〈0.01 ） ; After the treatment, LVMI in the LVH and NLVH groups dropped signifcantly, but it was higher than that of the control group, 119.32 ± 12.34 and 111.81 ± 11.21 vs 89.03± 24.38 （ P 〈0.01）. Blood pressure had positive correlation with serum hsCRP（ r = 0. 203, P 〈 0.05）. Conclusion Level of serum hsCRP is positive correlated with blood pressure in LVH group. The inflammation possibly participates in hypertension development. Amlodipine can not only make blood pressure decrease steadily but also revert essential hypertension with LVH.