氨氯地平+阿托伐他汀对吸烟的高血压患者血压的影响及其与血浆一氧化氮的关系

The Hypotentive Effect of Amlodipine with Atorvastatin to Smoking Hypertensive Patients and the Relationship between the Hypotentive Effect and the Change of Nitrogen Monoxidum

目的：研究苯磺酸氨氯地平＋阿托伐他汀在吸烟和不吸烟高血压患者降压作用的差异及其与血浆一氧化氮（NO）变化的关系。方法：1-2级高血压患者60例分为两组；吸烟组30例,不吸烟组30例,先给予氨氯地平5mg治疗6周,再加用阿托伐他汀10mg,治疗6周。比较治疗前、治疗6周后和治疗12周后的诊所血压、低密度脂蛋白胆固醇（LDL）和血浆NO含量的变化。结果：吸烟组氨氯地平治疗后的收缩压下降及不吸烟组氨氯地平治疗后的收缩压（SBP）和舒张压（DBP）下降与氨氯地平加阿托伐他汀治疗后相比无显著差异,吸烟组DBP下降氨氯地平加阿托伐他汀治疗组显著大于氨氯地平组,两组氨氯地平＋阿托伐他汀治疗后血浆NO水平升高显著大于氨氯地平治疗后,LDL水平明显的低于氨氯地平治疗后。结论：阿托伐他汀在氨氯地平治疗基础上对吸烟高血压患者的DBP进一步降低有显著作用,可能与阿托伐他汀能够显著改善吸烟对高血压患者血管内皮功能损害相关。

Objective：To study the difference of hypotentive effect of amlodipine with atorvastatin for smoking and non-smoking hypertensive patients and the relationship between the difference and the change of nitrogen monoxidum（NO）.Methods：60 patients with essential hypertension（EH）（class I to II） were investigated. Half of those patients were smokers and the others were non-smokers. All patients were treated with amlodipine 5mg/d for 6 weeks first and then treated together with atorvastatin 10mg/d for 6 weeks. Before and at the end of 6 weeks and 12 weeks treatment,clinic blood pressure,low density lipoprotein cholesterol（LDL） and NO were measured. Results：There were no significant differences of the decrease of SBP in smoking and non-smoking EH patients between amlodipine treatment group and amlodipin＋atorvastatin treatment group. Neither was the decrease of DBP in non-smoking EH patients. The decrease of DBP in smoking EH patients treated after amlodipine＋atorvastatin were significant greater than that treated after amlodipine. The increase of NO and the decrease of LDL in both smoking and non-smoking EH patients treated after amlodipine＋atorvastatin were significant greater than those treated after amlodipine. Conclusions：Atorvastatin treatment could significantly decrease DBP on the basis of amoldipine treatment in smoking EH patients. This kind of further decrease of DBP might be associated with the improvement of endothelium function in smoking EH patients treated after atorvastatin.