摘要
目的探讨阿托伐他汀对血脂正常的1-2级原发性高血压（低危或中危）患者血压、血压变异性（BPV）和高敏C反应蛋白（hs-CRP）的影响。方法选择生活方式干预至少三个月后血脂正常的1-2级原发性高血压患者（危险分层为低危或中危）102例。随机分为他汀组（n=51）和对照组（n=51）。两组患者在生活方式干预的基础上均予以咪达普利10 mg/d治疗,他汀组在咪达普利治疗的基础上加用阿托伐他汀20 mg/d,治疗3个月。治疗前、后所有患者均行24 h动态血压监测,观察两组治疗前、后血压平均值、BPV和血清hs-CRP浓度的变化,并探讨BPV与hs-CRP的相关关系。结果治疗后两组患者24 h平均收缩压（24 h SBP）、24 h平均舒张压（24 h DBP）、白昼平均收缩压（dSBP）、白昼平均舒张压（dDBP）、夜间平均收缩压（nSBP）、夜间平均舒张压（nDBP）均较治疗前明显降低（P〈0.01）,但与对照组比较,他汀组下降更为显著（P〈0.05）;他汀组24 h收缩压标准差（24 h SSD）、24 h舒张压标准差（24 h DSD）、白昼收缩压标准差（dSSD）、白昼舒张压标准差（dDSD）、夜间收缩压标准差（nSSD）和夜间舒张压标准差（nDSD）及血清hs-CRP浓度均显著降低（P〈0.05）,而对照组治疗后上述血压变异参数和血清hs-CRP浓度无明显变化（P〉0.05）。直线相关分析显示治疗前102例患者24 h SSD、dSSD、nSSD与血清hs-CRP浓度呈正相关（相关系数和P值分别为：0.296,P〈0.05;0.401,P〈0.01;0.288,P〈0.05）,而24 h DSD、dDSD、nDSD与hs-CRP无相关关系（P〉0.05）。结论阿托伐他汀降低血脂正常的1-2级高血压患者血压、BPV及血清hs-CRP浓度,其降低血压和BPV的机制可能与其抗炎作用有关。
【Objective】To investigate the effects of Atorvastatin on blood pressure and blood pressure variability（BPV） and high-sensitivity C-reactive protein（hs-CRP） in patients with hypertension and normal lipidemia.【Methods】One hundred and two patients with essential hypertension（grade 1 or grade 2 with low risk or moderate risk） and normal lipidemia were chosen. After lifestyle intervention for at least 3 months, the patients were randomly divided into two groups： Treatment group and control group. Each of both groups received midapril 10 mg/d and lifestyle intervention. The patient in the treatment group was added Atorvastatin 20 mg/d. 24 hours average blood pressure（24 h ABP）, blood pressure variability（BPV） and serum hs-CRP were measured before and after the treatment. 【Results】After the treatment, significant declines of 24 h systolic blood pressure（24 h SBP）, 24 h diastolic blood pressure（24 h DBP）, daytime systolic blood pressure（dSBP）, daytime diastolic blood pressure（dDBP）, nighttime systolic blood pressure（nSBP）, nighttime diastolic blood pressure（nDBP） were observed in both groups（P〈 0.01）,but compared with the control group, these index were decreased further in the treatment group（P〈 0.001）. Compared with before the treatment, significant decline of 24 h systolic pressure standard deviation（24 h SSD）, 24 h diastolic pressure standard deviation（24 h DSD）, daytime systolic pressure standard deviation（dSSD）, daytime diastolic pressure standard deviation（dDSD）, nighttime systolic pressure standard deviation（nSSD）, nighttime diastolic pressure standard deviation（nDSD） and serum hs-CRP were observed in treatment group after the treatment（P〈 0.05P〈 00.01）,but no significant change was found in these index in control group after the treatment（P〈 0.05）. Linear correlation analysis showed that the 24 h SSD, dSSD and nSSD are positively correlated to the hs-CRP separately in 102 patients with essential hypertension（r =0.296, P〈 0.05; 0.401, P〈 0.01; 0.288, P〈 0.05）. 【Conclusions】Atorvastatin may reduce the blood pressure, BVP and serum hs-CRP in patients with hypertension and normal lipidemia. The mechanism might be involved to the anti-inflammatory effect produced by Atorvastatin.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2014年第24期102-106,共5页
China Journal of Modern Medicine
关键词
高血压
血压
血压变异性
阿托伐他汀
高敏C反应蛋白
hypertension blood pressure blood pressure variability Atorvastatin high-sensitivity C-reactive protein
