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目的评价硝苯地平控释片联用阿托伐他汀对原发性1、2级高血压患者血压及血管内皮功能的影响。方法将82例原发性1、2级高血压患者分为对照组(40例)和联用组(42例)。采用随机双盲对照试验给药,对照组给予硝苯地平控释片30 mg/d,联用组给予:硝苯地平控释片30 mg/d,阿托伐他汀10 mg/d。另设30例正常血压者为正常血压组。12周后观察2组血压及血浆内皮素-1、一氧化氮水平的变化,评价联用阿托伐他汀对原发性1、2级高血压患者血压及血管内皮功能的影响。结果2组的收缩压和舒张压均有显著降低,但联用组较对照组有显著下降(P<0.05,P<0.01)。联用组血浆内皮素-1水平较治疗前降低35.9%(P<0.01),较对照组治疗后降低20.6%(P<0.05);一氧化氮水平较治疗前升高100.3%(P<0.01),较对照组治疗后升高62.9%(P<0.01)。结论阿托伐他汀与硝苯地平控释片联用有明显的协同降压作用,并伴随有血管内皮功能的改善,这可能是他汀类药物发挥协同降压作用的机制之一。
Objective To evaluate the effects of nifedipine controlled release tablets combined with atorvastatin on blood pressure and endothelial function in patients with primary hypertension and grade 1,2 hypertension. Methods Eighty-two patients with primary and secondary hypertension were divided into control group (40 cases) and combination group (42 cases). The control group was given nifedipine 30 mg / d, and the control group was given nifedipine 30 mg / d and atorvastatin 10 mg / d respectively. Another set of 30 cases of normal blood pressure for the normal blood pressure group. After 12 weeks, the changes of blood pressure, plasma endothelin-1 and nitric oxide were observed to evaluate the effect of atorvastatin on blood pressure and endothelial function in patients with primary hypertension. Results The systolic and diastolic blood pressure of the two groups were significantly decreased, but the combined group was significantly lower than the control group (P <0.05, P <0.01). Compared with the control group, the plasma endothelin-1 level decreased by 35.9% (P <0.01) and decreased by 20.6% (P <0.05), while the level of nitric oxide increased 100.3% (P <0.01) ), Which was 62.9% higher than that of the control group (P <0.01). Conclusions Combination of atorvastatin and nifedipine controlled release tablets has obvious synergistic antihypertensive effect with the improvement of vascular endothelial function, which may be one of the mechanisms by which statins exert synergistic antihypertensive effect.