辛伐他汀对高血压患者血压及左心室结构的影响

The impact on left ventricular structure in the treatment of community primary hypertension by simvastatin

目的观察辛伐他汀对社区原发性高血压患者血压及左心室结构的影响,提高社区原发性高血压治疗效果及改善预后。方法将280例符合入组标准的原发性高血压患者按随机数字表分为观察组140例和对照组140例,对照组给予氨氯地平治疗,5 mg/次,1次/d,观察组在对照组基础上再口服辛伐他汀治疗,20 mg/次,1次/d,2组均治疗8周,治疗前后观察血压变化情况,检查血脂水平变化情况,并采用超声心动图检查评价心肌肥厚程度,记录不良反应发生情况。结果①观察组和对照组总有效率分别为95.00%、83.57%,差异具有统计学意义,χ2=16.311,P<0.01;②观察组与对照组治疗前SBP、DBP、TC、TG、IVST、LVPWT、LVDd差异没有统计学意义,具有可比性,观察组与对照组治疗后SBP、DBP、TC、TG、IVST、LVPWT、LVDd分别为(131±4)mm Hg vs.(139±5)mm Hg,(78±6)mm Hg vs.(91±6)mm Hg,(4.02±0.95)mmol/L vs.(5.24±1.05)mmol/L,(1.05±0.86)mmol/L vs.(1.55±1.00)mmol/L,(9.3±1.6)mm vs.(11.1±1.8)mm,(10.0±1.5)mm vs.(11.9±1.7)mm,(44.4±2.2)mm vs.(49.3±3.3)mm,各个指标差异具有统计学意义,均P<0.05(1mm Hg=0.133 kPa)。结论辛伐他汀联合氨氯地平能协同降低血压及逆转左室肥厚,降低靶器官损伤,改善预后,效果优于单纯氨氯地平治疗,值得临床推广使用。

Objective To observe the impact on the blood pressure and left ventricular structure in the treatment of com- munity primary hypertension by simvastatin and amlodipine and to improve the effect of community primary hypertension and improve the prognosis. Methods 280 community primary hypertension patients met the inclusion criteria were divid- ed into 140 cases of the observation group and 140 cases of the control group by random number table, the control group was given amlodipine 5 mg qd, the observation group was given simvastatin 20 mg qd on the basis of the control group, two group were treated for eight weeks, the blood pressure was observed, the lipid was checked and myocardial hypertrophy was evaluated by echocardiography before and after treatment, the adverse reactions were recorded. Results ①the total efficiency of the observation group and the control group were 95.00% and 83.57%, respectively, there were a statistical- ly significant difference ,X^2 = 16.311, P 〈 0.01 ; ②There were no difference in the SBP, DBP, TC, TG, IVST, LVPWT, LVDd between two groups, after treatment the SBP, DBP, TC, TG, IVST, LVPWT, LVDd of observation group and control group were （131±4）mmHgvs （139±5）mm Hg,（78±6）mm Hgvs （91 ±-6）mm Hg,（4.02±0. 95）mmol/L vs （5.24±1.05）mmol/L,（1.05±0. 86）mmolfL vs （1.55 ±1.00）mmol/L,（9.3±l.6）mm vs （11.1 ±l.8）mm, （ 10.0 ± 1.5 ）mm vs （ 11.9 ± 1.7 ） mm, （44.4 ± 2.2 ） mm vs （49.3 ± 3.3 ） mm, each index were significantly different, all P 〈 0.05. Conclusion The method containning Simvastatin with amlodipine can synergistically reduce blood pressure and reverse left ventricular hypertrophy, reduce target organ damage and improve prognosis, which was better than pure amlodipine treatment, should be worthy of clinical use.