辛伐他汀对老年冠心病患者血管内皮功能的影响

目的探讨辛伐他汀对冠心病患者血管内皮功能的作用。方法共入选120例冠心病患者,随机分为3组:对照组(不服用辛伐他汀),辛伐他汀组,正常对照组,每组40例,治疗8周。采用超声法检测血流介导的肱动脉内皮依赖性舒张功能(flux modulated dilation,FMD),同时观察血脂水平的变化。结果辛伐他汀治疗8周后,显著降低血总胆固醇和低密度脂蛋白胆固醇水平。对照组治疗8周后血脂水平无明显变化(P>0.05)。辛伐他汀可显著改善FMD百分比(P<0.05)。但3组之间FMD的改善与血TC、LDL-C水平的降低不相关。对照组FMD虽有轻度增加,但差异无统计学意义。辛伐他汀治疗后肱动脉内径、肱动脉对硝酸甘油的反应均无显著改变。结论辛伐他汀治疗8周后,可显著改善冠心病患者血管内皮功能,但该作用与血脂调节变化无明显的量效关系,可能独立于调脂作用之外。

Simvastatin on vascular endothelial function in old patients with coronary heart disease

[Objective] To explore the effects of simvastatin on vascular endothelial function in patients with coronary heart disease (CHD). [Methods] Total 120 patients with CHD were included and randomly divided into four groups: control group (no simvastatin) and simvatatin group, normal control group 40 patients in each group. The endothelial dependent flux modulated dilation(FMD) of brachial artery was measured by ultrasound technique before and after 8 weeks treatment. At the same time, the changes of lipids were examined. [Results] After 8 weeks treatment, simvastatin group apparently reduced the serum level of TC and the serum level of LDL-C. The values of P among different dose groups comparison were all less than 0.05. The serum levels of lipids in control group did not significantly change after therapy. The values of FMD apparently increased in simvastatin group (P <0.05). But there was no statistic difference among them. The increase of FMD did not relate to the changes of TC and LDL-C level in the serum. Although the value of FMD slightly increased in control group, it had no statistic significance. There was no significant change of vasodilation response to nitroglycerin and brachial diameter in all groups after simvastatin therapy. [Conclusion] Simvastatin can obviously improve the vascular endothelial function of patients with CHD in 8 weeks. But it has no obvious dose effect relationship and it may not relate to lipid-lowering action.