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目的探讨血脂正常或轻度升高的高血压患者降压治疗中加用他汀类药物在血压控制、脂质过氧化、炎性反应、心肌纤维化等方面是否产生有益效应。方法采用随机、单盲、安慰剂对照研究。120例血脂正常或轻度升高的高血压病患者,随机分至血脂康组及对照组,分别给予血脂康或安慰剂治疗24周.降压药物均选用硝苯地平缓释片(商品名:伲福达)。治疗过程中每周测量血压,于试验前、试验结束分别检测血浆Ⅰ型胶原羧基端前肽、超氧化物歧化酶发光抑制率、丙二醛浓度。结果血脂康组较之安慰剂组血压达标率增加(49/51比40/49,P<0.01),脉压减小[(43±8)mm Hg(1 mm Hg=0.133 kPa)比(50±12)mm Hg]。血脂康治疗未增加超氧化物歧化酶活性,但可以降低丙二醛、Ⅰ型胶原羧基端前肽及 C 反应蛋白的水平。结论在血脂正常或轻度升高的高血压患者中,加用血脂康可以减轻抗氧化负荷,减弱炎症反应、改善心肌纤维化相关指标,进而改善内皮细胞功能,提高血压达标率。
Objective To investigate if statin treatment with antihypertensive therapy in patients with normal or mild hyperlipidemia has beneficial effect on blood pressure control, lipid peroxidation, inflammatory reaction and myocardial fibrosis. Methods Randomized, single-blind, placebo-controlled study. 120 cases of normal or slightly elevated blood pressure in patients with hypertension were randomly divided into Xuezhikang group and control group, were given Xuezhikang or placebo for 24 weeks.The antihypertensive drugs were selected nifedipine sustained-release tablets (trade name : 伲 Fuda). During the course of treatment, blood pressure was measured weekly. Before the test and at the end of the experiment, the plasma type Ⅰ collagen carboxyterminal propeptide, superoxide dismutase inhibition rate and malondialdehyde concentration were respectively measured. Results The blood pressure compliance rate in Xuezhikang group was higher than that in placebo group (49/51 vs 40/49, P <0.01), and the decrease of pulse pressure was (43 ± 8) mm Hg (1 mm Hg = 0.133 kPa) ± 12) mm Hg]. Xuezhikang treatment did not increase superoxide dismutase activity, but can reduce the level of malondialdehyde, type Ⅰ collagen carboxyterminal peptide and C-reactive protein. Conclusion In patients with normal or mild hyperlipidemia, adding Xuezhikang can reduce the anti-oxidative load, reduce the inflammatory reaction and improve the index of myocardial fibrosis, then improve the function of endothelial cells and improve the rate of blood pressure compliance.