【摘要】 目的探讨阿托伐他汀对高血压早期肾损害的影响。方法对55例经氨氯地平降压治疗达到高血压1级及以下标准的高血压患者随机分为实验组(n=27)和对照组(n=28),实验组予以阿托伐他汀10mg/d和氨氯地平,对照组只给予氨氯地平。两组治疗前及治疗后12周检测24h动态血压、空腹血脂和尿微量白蛋白(MAU)、尿β2-微球蛋白(β2-MG)、N-乙酰-β-D氨基葡萄糖苷酶(NAG)。结果两组治疗后12周,24h收缩压(SBP)和舒张压(DBP)、白昼和夜间SBP及DBP均较治疗前明显下降(P均<0.01),但实验组下降更为显著(P均<0.01),SBP和DBP平滑指数也优于对照组(P均<0.01)。治疗前后两组血脂无明显变化(P>0.05);实验组MAU、β2-MG和NAG较治疗前显著下降[MAU:(42.2±14.9)vs实验后(18.2±12.1)mg/L,β2-MG:(6.2±1.4)vs实验后(3.5±0.8)mg/L,NAG:(28.5±14.7)vs实验后(17.9±9.5)U/L,P均<0.01],并低于同期的对照组(P<0.01),对照组仅MAU较治疗前下降(P<0.01)。结论阿托伐他汀具有一定的协同降压作用,并可能改善高血压早期肾损害的相关指标。更多还原

【Abstract】 Objective To study the effect of atorvastatin on early renal damage and blood pressure in patients with essential hypertension. Methods After receiving amlodipine (5 mg/d) and reaching target BP ≤ grade 1 level, 55 patients were assigned randamly to amlodipine montherapy (n=28) or amlodipine combined with atorvastatin (10 mg/d) for another 12 weeks. Ambulatory blood pressure (ABPM), urine microalbumin (MAU), urinar β2-microgloblin (β2-MG), and N-acetyl-beta-glucosaminidase (NAG) were determined before and after 12 weeks treatment. Results 24 h SBP, 24 h DBP, DSBP, DDBP, NSBP and NDBP were decreased in both groups after 12 weeks treatment(P<0.01). The extent of reduction of above mentioned BP paramenters were greater in combined group than that in monotherapy group. Smoothness indexes of SBP and DBP in combined group are higher(P<0.01). MAU,β2-MG and NAG were decreased in combined group (MAU:42.2±14.9 vs after:18.2±12.1 mg/L,β2-MG:6.2±1.4 vs after:3.5±0.8 mg/L, NAG:28.5±14.7 vs after:17.9±9.5 U/L, P all<0.01), however, only MAU was decreased in monotherapy group(P<0.01). Conclusion Combined atorvastatin with amlodipine treatment improved blood pressure control and ameliorate early damaged renal function in hypertensive patients.更多还原