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目的:观察阿托伐他汀对原发性高血压(EH)过氧化损伤及心肌纤维化的影响。方法:将59例EH患者随机分为阿托伐他汀组(30例)和对照组(29例)。两组均以贝那普利(10mg/d)和螺内酯(20mg/d)控制血压。阿托伐他汀组加用阿托伐他汀20mg/d。测定治疗前后血清一氧化氮(NO)、超氧化物歧化酶(SOD)、丙二醛(MDA)及Ⅲ型前胶原末端肽(PⅢP)、Ⅳ型前胶原末端肽(PⅣP)水平,同时观察左室结构及舒缩功能变化。结果:治疗12周后,两组患者平均动脉压、MDA、PⅢP、PⅣP及左室质量指数(LVMI)较治疗前均有降低(P<0.05或P<0.01),且以阿托伐他汀组降低更明显,与对照组比较差异有统计学意义(P<0.05或P<0.01);NO、SOD水平及左室舒张功能较治疗前均有明显改善,也以阿托伐他汀组改善更显著(P<0.05或P<0.01)。NO、SOD和MDA与PⅢP水平存在显著的相关性。结论:EH患者在接受常规降压治疗的同时,加用阿托伐他汀可更好地控制血压,显著减轻过氧化损伤和心肌纤维化,改善心脏功能。
Objective: To observe the effect of atorvastatin on peroxidation and myocardial fibrosis in patients with essential hypertension (EH). Methods: 59 patients with EH were randomly divided into atorvastatin group (30 cases) and control group (29 cases). Both groups controlled their blood pressure with benazepril (10 mg / d) and spironolactone (20 mg / d). Atorvastatin group with atorvastatin 20mg / d. The level of serum nitric oxide (NO), superoxide dismutase (SOD), malondialdehyde (MDA), type III procollagen peptide (PⅢP) and type Ⅳ procollagen peptide (PⅣP) were measured before and after treatment. Left ventricular structure and changes in systolic and diastolic function. Results: After 12 weeks of treatment, mean arterial pressure, MDA, PⅢP, P Ⅳ P and left ventricular mass index (LVMI) of patients in both groups were significantly lower than those before treatment (P <0.05 or P <0.01) (P <0.05 or P <0.01). The level of NO and SOD and the diastolic function of left ventricle were significantly improved compared with those before treatment, and the improvement was more obvious in atorvastatin group (P <0.05 or P <0.01). There was a significant correlation between NO, SOD, MDA and PⅢP levels. Conclusion: Atorvastatin combined with conventional antihypertensive treatment can be used to control blood pressure and reduce the damage of peroxisome and myocardial fibrosis and improve cardiac function.