超声观察辛伐他丁对原发性高血压左室重量的作用

目的: 研究辛伐他丁对原发性高血压(EH) 患者左室重量(LVM) 的影响。方法: 采用随机、对照、单盲法将50 例EH 患者分为两组:联合用药组(口服辛伐他丁和利尿剂)、利尿药组(口服利尿剂) 各25 例, 超声观察治疗12 周前后患者左室重量指数(LVMI)。25 例正常人作为对照组, 不予任何治疗。结果: 与正常对照组(88.79±22.73 g^。m^-2) 相比, 治疗前两组患者的LVMI 均增大(133.61±31.02,118.04±39.62 g^。m^-2, P <0.01 或0.0001), 血压增高, 而年龄、血脂、血糖无显著性差异(P >0.05)。治疗后联合用药组患者的LVMI 显著减小(91.07±16.01 g^。m^-2 VS 133.61±31.02 g^。m^-2, P <0.01),而利尿药组LVMI 无明显改变;联合用药组患者的左室重量指数变化率(LVMICH) 较利尿药组显著增大(P <0.05), 而血压、血糖、血脂无显著差异。治疗前后两组患者的血压下降至正常, 但血脂、血糖无显著性变化。相关分析显示, 联合用药组患者的左室重量指数变化率与血压、血糖和血脂的变化率间无有意义相关性(P >0.05)。结论: 辛发他丁可以抑制EH 患者左室重量增加, 这一作用不依赖血压和血脂、血糖等改变独立存在。

Ultrasonic study on effects of simvastatin on left ventricular mass in patients with essential hypertension

AIM: To evaluate the effect of simvastatin on the left ventricular mass in patients with essential hypertension (EH).METHODS: 50 patients with hypertension without severe complication were randomly divided into two treatment groups:combination treatment group and hydragogue group, and 25 normal subjects without any treatment were taken as the control.The 25 patients in combination treatment group were given simvastatin and hydragogue for 12 weeks while the other patients in hydragogue group were given hydragogue during the same time.The left ventricular mass was examined from ultrasonography in all patients before and after treatment.RESULTS: The left ventricular mass index (LVMI) was higher in the two treatment groups of patients (133.61±31.02, 118.04±39.62 g^。m^-2) than that in the control group (88.79±22.73 g^。m^-2) before treatment (P <0.01, 0.0001, respectively) while the blood pressure was higher.There was no significantly difference in age, serum concentrations of total cholesterol or triglyceride, sugar and blood pressure between the two treatment groups and the control group (P >0.05).There was no significant difference in all variables between the two treatment groups before treatment.After treatment, the LVMI was decreased (133.61±31.02 vs 91.07±16.01 g^。m^-2, P <0.01) in the combination treatment group while there was no significant change in LVMI in the hydragogue group compared with the control group.The blood pressure in the two treatment groups was decreased to the normal.Compared with hydragogue group, the change of LVMI was higher in the combination group though the serum concentrations of total cholesterol, triglyceride or sugar were not significantly different.No significant change in serum concentrations of total cholesterol, triglyceride or sugar was found during treatment in the two groups.The change of LVMI did not correlate with the change of blood pressure, serum concentrations of total cholesterol, triglyceride or sugar in the combination treatment group(P >0.05).CONCLUSION: Being independent of the changes of serum concentrations of total cholesterol, triglyceride or sugar and blood pressure, simvastatin can inhibit the increase of left ventricularmass in patients with essential hypertension.