瑞舒伐他汀联用雷米普利对高血压患者自主神经功能、血压变异性的影响
Effect of Rosuvastatin combined with Ramipril on autonomic nerve function and blood pressure variability in patients with hypertension

余冬梅.瑞舒伐他汀联用雷米普利对高血压患者自主神经功能、血压变异性的影响[J].内科急危重症杂志,2017,23(6):482-485

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DOI：10.11768/nkjwzzzz20170612

中文关键词: 瑞舒伐他汀雷米普利高血压自主神经功能血压变异性血管内皮功能血浆内皮素超敏C反应蛋白

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作者	单位	E-mail
余冬梅	遂宁市中心医院	642838145@qq.com

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中文摘要:

目的:探讨瑞舒伐他汀联用雷米普利对高血压患者自主神经功能、血压变异性及血管内皮功能的影响。方法:采用随机数字表法将108例高血压患者分为对照组与观察组，每组54例，其中,对照组患者仅给予雷米普利口服治疗，观察组患者给予瑞舒伐他汀联合雷米普利口服治疗，比较2组患者治疗前、后血脂、超敏C反应蛋白(hs-CRP)、心率变异性、血压变异性、血浆内皮素和一氧化氮(NO)水平的变化。结果：治疗后，2组患者血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）及hs-CRP水平均显著降低（均P<0.05），高密度脂蛋白胆固醇（HDL-C）水平明显升高（均P<0.05），且观察组改善明显优于对照组（均P<0.05）；治疗后，2组患者自主神经功能各项指标均显著增加，且观察组患者上述各指标改善效果明显优于对照组（均P<0.05）；治疗后，观察组白昼收缩压变异性（SBPV）、夜间SBPV、24hSBPV、白昼舒张压变异性（DBPV）、夜间DBPV以及24h DBPV均明显降低（均P<0.05）；但对照组患者治疗后上述各指标未见明显改善（P>0.05）；治疗后，2组患者血清内皮素水平均明显降低，而一氧化氮水平均明显增高，且观察组该2项指标改善明显优于对照组（P<0.05）；2组患者均未见明显不良反应（P>0.05）。结论：瑞舒伐他汀联用雷米普利治疗高血压患者能够明显降低患者血脂及hs-CRP水平，同时对患者自主神经功能、血压变异性以及血管内皮功能均有显著改善作用。

英文摘要:

Objective: To explore the effect of Rosuvastatin combined with Ramipril on autonomic nerve function, blood pressure variability and blood vessel endothelium function in patients with hypertension. Methods: A total of 108 patients with hypertension were divided into control group and observation group (54 cases in each group). Control group was treated with Ramipril, and observation group was treated with Rosuvastatin combined with Ramipril. The serum lipid, hypersensitive C-reactive protein, heart rate variability, blood pressure variability, and plasma endothelin and nitric oxide levels were compared between two groups before and after treatment. Results: After treatment, the total cholesterol, triglyceride, low density lipoprotein cholesterol and hypersensitive C-reactive protein (hs-CRP) levels were significantly reduced, and the high density lipoprotein cholesterol levels were increased markedly in both two groups as compared with those before treatment, more significantly in the observation group than in control group (all P<0.05). After treatment, the various indicators of autonomic nerve function were improved significantly, and each of these indicators in observation group was improved more significantly than in control group (P<0.05). After treatment, the levels of day time systolic blood pressure variability (SBPV), night time SBPV, 24h SBPV, day time diastolic blood pressure variability (DBPV), night time DBPV and 24h DBPV in observation group were significantly lowered (all P<0.05), but those in control group showed no obvious improvement (P>0.05). After treatment, the endothelin levels were significantly decreased and the nitric oxide levels were significantly increased in both two group, more significantly in observation group than in control group (P<0.05). There were no significant adverse reactions in both two groups (P>0.05). Conclusion: Rosuvastatin combined with Ramipril in the treatment of hypertension not only can reduce serum lipid and hs-CRP levels, but also can significantly improve the autonomic nerve function, blood pressure variability and blood vessel endothelium function.