中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2009年
9期
800-803
,共4页
刘晓红%李怡霏%来春林%冀友瑞%赵建强
劉曉紅%李怡霏%來春林%冀友瑞%趙建彊
류효홍%리이비%래춘림%기우서%조건강
高血压%内皮素%辛伐他汀
高血壓%內皮素%辛伐他汀
고혈압%내피소%신벌타정
Hypertension%Endothelin%Simvastatin
目的 了解原发性高血压(EH)不同合并症患者血浆内皮素(ET)浓度的变化及辛伐他汀干预对其影响.方法 入选EH患者149例,根据合并症的不同分为单纯EH组44例,EH合并左心室肥厚(EH-LVH)组40例,EH合并心房颤动(EH-AF)组36例,EH合并腔隙性脑梗死(EH-LI)组29例,同时选择30例健康体检者作为对照.149例EH患者按血压水平随机分为常规治疗组(主要应用钙拮抗剂、血管紧张素转换酶抑制剂、利尿剂、β受体阻滞剂等药治疗8周)和辛伐他汀干预组(常规治疗+辛伐他汀40 mg/d),药物治疗前后检测血浆内皮素.结果 (1)EH组ET浓度高于对照组[(71.42±6.62)pg/ml对(45.52±8.28)pg/ml,P<0.01]并与血压升高程度呈正相关(r=0.746,P<0.001),EH-LVH组、EH-AF组、EH-LI组ET浓度均高于EH组[(97.67±10.53)pg/ml、(102.15±12.96)pg/ml、(103.49±9.91)pg/ml对(71.42±6.62)pg/ml,P<0.01],ET浓度变化均与血压升高程度呈正相关(r=0.671,r=0.592,r=0.530,P均<0.001).(2)EH-AF组左心房内径与ET浓度呈正相关(r=0.684,P<0.001);EH-LVH组的左心室质量指数与ET浓度呈正相关(r=0.545,P<0.001).(3)EH-LVH组、EH-AF组、EH-LI组的3级高血压所占的百分比均高于EH组.(4)EH 3级辛伐他汀干预组治疗后血压水平较常规治疗组下降更为显著(P<0.05).(5)EH 2级辛伐他汀干预组治疗后ET水平较常规治疗组显著降低(P<0.05),EH 3级辛伐他汀干预组和常规治疗组治疗后ET水平均显著降低(P<0.05),但辛伐他汀干预组下降更为显著(P<0.05).结论 ET水平与EH的严重程度呈正相关,辛伐他汀干预能更显著降低EH患者ET水平和EH3级患者的血压,提示对EH患者在使用降压药物控制血压的同时合用他汀类药物可能更有益.
目的 瞭解原髮性高血壓(EH)不同閤併癥患者血漿內皮素(ET)濃度的變化及辛伐他汀榦預對其影響.方法 入選EH患者149例,根據閤併癥的不同分為單純EH組44例,EH閤併左心室肥厚(EH-LVH)組40例,EH閤併心房顫動(EH-AF)組36例,EH閤併腔隙性腦梗死(EH-LI)組29例,同時選擇30例健康體檢者作為對照.149例EH患者按血壓水平隨機分為常規治療組(主要應用鈣拮抗劑、血管緊張素轉換酶抑製劑、利尿劑、β受體阻滯劑等藥治療8週)和辛伐他汀榦預組(常規治療+辛伐他汀40 mg/d),藥物治療前後檢測血漿內皮素.結果 (1)EH組ET濃度高于對照組[(71.42±6.62)pg/ml對(45.52±8.28)pg/ml,P<0.01]併與血壓升高程度呈正相關(r=0.746,P<0.001),EH-LVH組、EH-AF組、EH-LI組ET濃度均高于EH組[(97.67±10.53)pg/ml、(102.15±12.96)pg/ml、(103.49±9.91)pg/ml對(71.42±6.62)pg/ml,P<0.01],ET濃度變化均與血壓升高程度呈正相關(r=0.671,r=0.592,r=0.530,P均<0.001).(2)EH-AF組左心房內徑與ET濃度呈正相關(r=0.684,P<0.001);EH-LVH組的左心室質量指數與ET濃度呈正相關(r=0.545,P<0.001).(3)EH-LVH組、EH-AF組、EH-LI組的3級高血壓所佔的百分比均高于EH組.(4)EH 3級辛伐他汀榦預組治療後血壓水平較常規治療組下降更為顯著(P<0.05).(5)EH 2級辛伐他汀榦預組治療後ET水平較常規治療組顯著降低(P<0.05),EH 3級辛伐他汀榦預組和常規治療組治療後ET水平均顯著降低(P<0.05),但辛伐他汀榦預組下降更為顯著(P<0.05).結論 ET水平與EH的嚴重程度呈正相關,辛伐他汀榦預能更顯著降低EH患者ET水平和EH3級患者的血壓,提示對EH患者在使用降壓藥物控製血壓的同時閤用他汀類藥物可能更有益.
목적 료해원발성고혈압(EH)불동합병증환자혈장내피소(ET)농도적변화급신벌타정간예대기영향.방법 입선EH환자149례,근거합병증적불동분위단순EH조44례,EH합병좌심실비후(EH-LVH)조40례,EH합병심방전동(EH-AF)조36례,EH합병강극성뇌경사(EH-LI)조29례,동시선택30례건강체검자작위대조.149례EH환자안혈압수평수궤분위상규치료조(주요응용개길항제、혈관긴장소전환매억제제、이뇨제、β수체조체제등약치료8주)화신벌타정간예조(상규치료+신벌타정40 mg/d),약물치료전후검측혈장내피소.결과 (1)EH조ET농도고우대조조[(71.42±6.62)pg/ml대(45.52±8.28)pg/ml,P<0.01]병여혈압승고정도정정상관(r=0.746,P<0.001),EH-LVH조、EH-AF조、EH-LI조ET농도균고우EH조[(97.67±10.53)pg/ml、(102.15±12.96)pg/ml、(103.49±9.91)pg/ml대(71.42±6.62)pg/ml,P<0.01],ET농도변화균여혈압승고정도정정상관(r=0.671,r=0.592,r=0.530,P균<0.001).(2)EH-AF조좌심방내경여ET농도정정상관(r=0.684,P<0.001);EH-LVH조적좌심실질량지수여ET농도정정상관(r=0.545,P<0.001).(3)EH-LVH조、EH-AF조、EH-LI조적3급고혈압소점적백분비균고우EH조.(4)EH 3급신벌타정간예조치료후혈압수평교상규치료조하강경위현저(P<0.05).(5)EH 2급신벌타정간예조치료후ET수평교상규치료조현저강저(P<0.05),EH 3급신벌타정간예조화상규치료조치료후ET수평균현저강저(P<0.05),단신벌타정간예조하강경위현저(P<0.05).결론 ET수평여EH적엄중정도정정상관,신벌타정간예능경현저강저EH환자ET수평화EH3급환자적혈압,제시대EH환자재사용강압약물공제혈압적동시합용타정류약물가능경유익.
Objective To observe the association between plasma endothelin (ET) concentration and blood pressure level in essential hypertensive (EH) patients with or without complications and possible impact of statins on ET concentration. Methods From Sep 2007 to Mar 2009, 149 patients with EH were analyzed [44 EH, 40 EH complicated by left ventricular hypertrophy (EH-LVH), 36 EH complicated by atrial fibrillation (EH-AF), and 29 EH complicated by lacunar infarction (EH-LI)], 30 healthy persons were selected as controls. EH patients were randomly divided into routine treatment group (calcium antagonists, ACEI, diuretics, β-receptor blocker for 8 weeks) and simvastatin intervention group (routine treatment + simvastatin 40 mg/d for 8 weeks), plasma ET concentrations before and after drug intervention were measured. Results (1) ET concentration was higher in EH group than that in control group[ (71.42 ±6.62) pg/ml vs. (45.52±8.28) pg/ml, P < 0.01 ]. ET concentration was higher in EH-LVH group, EH-AF group and EH-LI group than that in EH group [ (97.67±10.53) pg/ml, (102.15±12.96 ) pg/ml, (103.49±9.91) pg/ml vs. (71.42±6.62) pg/ml, P<0.01]. The degrees of elevated blood pressure was positively correlated with ET concentrations(all P < 0.001). (2) The left atrial diameters of EH-AF group were positively correlated with ET concentration (r = 0.684, P < 0.001). The left ventricular mass index of EH-LVH group were positively correlated with ET concentration (r = 0.545, P < 0.001). (3) The percentages of class 3 hypertension in EH-LVH group, EH-AF group and EH-LI group were higher than that in EH group (57.5%, 50.0%, 62.1% vs. 25,0% ,all P <0.05). (4) Blood pressure in class 3 hypertension patient treated with simvastatin decreased more significantly than that in routine treatment group(P <0.05). (5)ET concentration of class 2 hypertension patient treated with simvastatin decreased significantly than that in routine treatment group(P < 0.05). ET concentrations of class 3 hypertension patient treated with simvastatin and routine treatment patient decreased significantly after treatment (P < 0.05), and the former was lower (P < 0.05). Conclusion The level of ET were positively correlated with the severity of EH. Simvastatin could decrease the ET levels of patients with EH and blood pressure levels of patients with class 3 hypertension. It suggested that therapeutic alliance of antihypertensive drugs and statins could be benefit to patients with EH.
