降脂治疗对高血压患者动脉脉搏波传导速度的影响

Effect of Lipid-lowering Therapy on Artery Pulse Wave Conduction Velocity in Patients with Hypertension

目的:观察降脂治疗对轻中度高血压患者动脉脉搏波传导速度(PWV)的影响,并探讨其机制。方法:选择2013年2-10月本院收治的120例无高脂血症的轻中度高血压患者作为研究对象,采用随机数字表法分为降脂组和对照组,每组60例,两组患者均给予硝苯地平缓释片、缬沙坦控制血压,降脂组在此基础上加用阿托伐他汀钙降脂治疗,疗程12个月。观察比较治疗前后两组血压、臂踝动脉脉搏波传导速度(ba PWV)、血脂水平、高敏C反应蛋白(hs-CRP)和血浆内皮素(ET)的变化。结果:两组治疗前ba PWV、ET、hs-CRP水平均高于正常值,比较差异均有统计学意义(P<0.05);治疗后,两组SBP、DBP、ba PWV、ET及hs-CRP水平均优于治疗前,降脂组TC及LDL-C水平均优于治疗前,降脂组TC、LDL-C、ba PWV、ET及hs-CRP水平均优于对照组,以上比较差异均有统计学意义(P<0.05)。结论:对轻中度高血压患者,在控制血压基础上,加用降脂治疗,可进一步改善患者的ba PWV,降低hs-CRP和ET水平,对改善患者的血管功能状态有积极的临床意义。

Objective：To observe the effect of lipid-lowering therapy on pulse wave velocity in patients with mild to moderate hypertension and to explore its mechanism.Method：120 mild to moderate hypertension patients without hyperlipidemia in our hospital from February to October 2013 were selected and randomly divided into the control group and the lipid-lowering group,each group had 60 patients.All patients of the two groups were given Nifedipine and Valsartan to control the blood pressure,the lipid-lowering group was given Atorvastatin to reduce lipid on the basis of the above treatment.The therapeutic course was 12 months.The blood pressure,brachial ankle pulse wave velocity（baPWV）,blood lipid levels,high sensitive C reactive protein（hs-CRP） and endothelin（ET） of the two groups were detected and compared before and after treatment.Result：Before treatment,the levels of baPWV,ET and hs-CRP of the two groups were all higher than the normal ranges,the differences were statistically significant（P〈0.05）.The levels of SBP,DBP,baPWV,ET and hs-CRP of the two groups after treatment were all better than those before treatment.The levels of TC and LDL-C of the lipid-lowering group after treatment were better than those before treatment.The levels of TC,LDL-C,baPWV,ET and hs-CRP of the lipid-lowering group were better than those of the control group.The differences above were all statistically significant（P〈0.05）.Conclusion：For patients with mild to moderate hypertension,antihypertensive combined with lipid-lowering therapy can decrease the levels of baPWV,hs-CRP and ET obviously.It has a positive clinical significance in improving the state of vascular function.