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目的探讨瑞舒伐他汀对高血压患者左心室功能的影响。方法入选40～79岁血脂正常的1级或2级高血压患者168例,随机分瑞舒伐他汀治疗组(n=86)及对照组(n=82),治疗组在降压基础上加用瑞舒伐他汀(10mg/d,1次/晚),对照组常规降压治疗。随访12月,观察2组患者治疗前后血压、血脂、高敏C反应蛋白(hsCRP)的变化。采用核素心血池显像和彩色多普勒2种技术检查左心室功能参数的变化。结果随访2月时,与对照组比较,治疗组血压[收缩压(128.1±4.3)比(133.8±4.9)mmHg;舒张压(73.7±4.0)比(77.9±4.1)mmHg]下降更明显(P<0.05),血脂[总胆固醇(3.28±0.51)比(4.22±0.64)mmol/L;三酰甘油(1.02±0.23)比(1.21±0.31)mmol/L]改善明显(P<0.05),hsCRP及左心室功能参数[左心室高峰充盈率(LVPFR);左心室舒张末容积(LVEDV);左心室射血分数以及二尖瓣血流舒张早期与晚期最大流速比值(E/A)改善不明显(P>0.05);随访12月时与对照组比较,治疗组血压[收缩压(126.0±4.9)比(133.2±3.5)mmHg;舒张压(75.0±3.2)比(78.2±3.1)mmHg]降低(P<0.05)和hsCRP[(1.51±0.25)比(1.96±0.36)mmol/L]明显下降(P<0.05),左心室功能参数[LVPFR(2.78±0.21)比(2.08±0.43);LVEDV(108.5±7.2)比(133.0±9.0)mL;左心室射血分数(64.79±10.12)比(61.52±8.42)%;E/A(1.21±0.08)比(1.02±0.15)]明显改善(P<0.05)。结论对血脂正常的高血压患者,规范降压治疗基础上加用常规剂量瑞舒伐他汀能改善左心室功能。
Objective To investigate the effect of rosuvastatin on left ventricular function in hypertensive patients. Methods A total of 168 patients with grade 1 or grade 2 hypertension with normal lipid levels between 40 and 79 years old were randomly assigned to rosuvastatin treatment group (n = 86) and control group (n = 82) With rosuvastatin (10mg / d, 1 / night), the control group conventional antihypertensive treatment. All the patients were followed up for 12 months. The changes of blood pressure, blood lipid and high sensitivity C-reactive protein (hsCRP) were observed before and after treatment. The changes of left ventricular function parameters were examined by two methods of radionuclide blood pool imaging and color Doppler imaging. Results Compared with the control group, the blood pressure (systolic blood pressure (128.1 ± 4.3) vs (133.8 ± 4.9) mmHg and diastolic blood pressure (73.7 ± 4.0) vs (77.9 ± 4.1) mmHg decreased significantly in the treatment group at 2 months follow-up (P <0.05), and the level of total cholesterol (3.28 ± 0.51) vs (4.22 ± 0.64) mmol / L and triglyceride (1.02 ± 0.23) vs (1.21 ± 0.31) mmol / L] And left ventricular function parameters (LVPFR); left ventricular end-diastolic volume (LVEDV); left ventricular ejection fraction and early to late mitral diastolic velocity (E / A) were not significantly improved (P> 0.05). Compared with the control group, the blood pressure (systolic blood pressure (126.0 ± 4.9) vs (133.2 ± 3.5) mmHg and diastolic blood pressure (75.0 ± 3.2) (78.2 ± 3.1) mmHg] (P <0.05) and hsCRP [(1.51 ± 0.25) vs (1.96 ± 0.36) mmol / L], LVPFR (2.78 ± 0.21) (P <0.05). Compared with the control group (108.5 ± 7.2 vs 133.0 ± 9.0), the left ventricular ejection fraction (64.79 ± 10.12 vs 61.52 ± 8.42%, E / A <0.05). Conclusion In hypertensive patients with normal blood lipids, the standard dose of rosuvastatin can improve left ventricular function on the basis of standard antihypertensive treatment.