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背景瑞舒伐他汀是新型他汀类药物,比现有他汀类药物作用更强。瑞舒伐他汀能否减少原发性高血压(EH)患者的血管损害和发挥抗动脉粥样硬化作用,目前有关研究较少。目的观察瑞舒伐他汀对无脂代谢紊乱的EH患者尿白蛋白/肌酐及动脉粥样硬化的影响。方法EH患者76例随机分为单用常规降压药物组(常规组,氨氯地平5mg/d+替米沙坦80mg/d,n=37)和常规降压药物+瑞舒伐他汀(10mg,睡前服用)组(联合组,n=39)。所有入选患者均在入选及随机治疗后8月各测1次血压、尿白蛋白/肌酐、颈动脉内膜中层厚度(IMT)及冠状动脉钙化积分(CS),对比分析组内治疗前后上述指标变化和两组间的差异。结果常规组和联合组治疗前后收缩压和舒张压均有显著下降,联合组治疗后血压下降幅度[(36.6±3.5)/(10.5±1.6)mmHg]比常规组大[(33.1±2.2)/(6.5±1.3)mmHg,P<0.05];联合组治疗8月后,尿白蛋白/肌酐、颈动脉IMT及冠状动脉钙化积分(CS)均显著下降[尿白蛋白/肌酐(31.6±21.8)比治疗后(23.2±19.8)mg/g;IMT(0.95±0.32)比治疗后(0.84±0.28)mm;CS(2.35±2.13)比治疗后(1.71±1.68),均P<0.05];而常规组治疗8月后,尿白蛋白/肌酐、颈动脉IMT及冠状动脉钙化积分CS与治疗前相比差异无统计学意义(P>0.05)。结论在应用常规降压药物基础上加用瑞舒伐他汀可使EH患者尿白蛋白/肌酐、颈动脉IMT及冠状动脉钙化积分明显下降并进一步降低血压。
Background Rosuvastatin is a new statin that works better than existing statins. Rosuvastatin can reduce vascular damage in patients with essential hypertension (EH) and play anti-atherosclerotic effect, the current study less. Objective To observe the effect of rosuvastatin on urinary albumin / creatinine and atherosclerosis in EH patients with no lipid metabolism disorders. Methods A total of 76 patients with EH were randomly divided into two groups: conventional antihypertensive drug group (conventional group, amlodipine 5mg / d + telmisartan 80mg / d, n = 37) and conventional antihypertensive drugs plus rosuvastatin (10mg, Bedtime) group (combination group, n = 39). All the patients were enrolled in the study, and blood pressure, urinary albumin / creatinine, carotid artery intima-media thickness (IMT) and coronary artery calcification score (CS) Variations and differences between the two groups. Results The systolic and diastolic blood pressures of both the conventional group and the combined group were significantly decreased before and after treatment. The decrease of the blood pressure in the combined group [(36.6 ± 3.5) vs (10.5 ± 1.6) mmHg] was (33.1 ± 2.2) / (6.5 ± 1.3) mmHg, P <0.05]. Urinary albumin / creatinine, carotid artery IMT and coronary artery calcification score (CS) were significantly decreased in the combined group after 8 months treatment [urine albumin / creatinine (31.6 ± 21.8) (P <0.05) after treatment (23.2 ± 19.8) mg / g, IMT (0.95 ± 0.32) vs (0.84 ± 0.28) mm and CS (2.35 ± 2.13) after treatment After 8 months of treatment, urinary albumin / creatinine, carotid artery IMT and coronary artery calcification score CS were not significantly different from those before treatment (P> 0.05). Conclusions The addition of rosuvastatin on the basis of conventional antihypertensive drugs can significantly decrease urinary albumin / creatinine, carotid artery IMT and coronary artery calcification score and further lower blood pressure.