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目的探讨他汀类药物是否能够改善高血压病患者的心脏舒张功能。方法对100例血脂正常或轻度升高的高血压患者采用随机、单盲、安慰剂对照研究。分别给予血脂康或安慰剂治疗24周,两组降压药物均选用尼非地平缓释片。于试验前、试验结束分别检测血浆Ⅰ型前胶原羧基端肽、应用脉冲组织多普勒测量及记录舒张早期及舒张晚期最大速度。结果血脂康治疗组较之安慰剂组血压达标率增加,脉压减小。血脂康治疗24周后Ⅰ型前胶原羧基端肽的血浆水平降低。血脂康组治疗24周后右房室环与右心室游离壁交界处、右房室环与室间隔交界处、二尖瓣前瓣瓣环与室间隔交界处的舒张早期及舒张晚期最大速度之比增加,但无统计学意义(P>0.05);同安慰剂组相比,用药24周后,血脂康组二尖瓣后叶瓣环与左室侧壁交界处舒张早期及舒张晚期最大速度之比增加(P<0.05)。结论高血压患者加用血脂康可以使心肌纤维化的相关指标改善、血压降低、进而改善左室舒张功能。
Objective To investigate whether statins can improve diastolic function in patients with essential hypertension. Methods A randomized, single-blind, placebo-controlled study of 100 patients with normal or mild hyperlipidemia was conducted. Were given Xuezhikang or placebo for 24 weeks, two antihypertensive drugs were selected nifedipine sustained release tablets. At the end of the experiment, the plasma type Ⅰ procollagen carboxyterminal peptide was detected before and after the experiment. Pulsed Tissue Doppler was used to measure and record the maximum velocity of early diastole and late diastole. Results Xuezhikang treatment group than the placebo group increased blood pressure compliance rate, pulse pressure decreased. Serum level of type 1 procollagen carboxyterminal peptide decreased after 24 weeks of Xuezhikang treatment. In the Xuezhikang group, after 24 weeks of treatment, the junction between the right atrioventricular ring and the right ventricular free wall, the junction between the right atrioventricular ring and the ventricular septum, the early diastolic and early diastolic velocities at the junction of the anterior mitral valve annulus and ventricular septum Compared with placebo group, compared with placebo group, Xuezhikang mitral valve annulus and left ventricular wall at the junction of early diastolic and diastolic maximum velocity (P <0.05). Conclusion Hypertension patients with Xuezhikang myocardial fibrosis can improve the relevant indicators, lower blood pressure, thereby improving left ventricular diastolic function.