阿托伐他汀对混合型高脂血症患者血管内皮依赖性舒张功能的影响

目的　观察阿托伐他汀对混合型高脂血症患者血管内皮依赖性舒张功能的影响。方法　 60例混合型高脂血症患者进行 8周阿托伐他汀片 10mg/d ,口服治疗 ,60例健康人群为对照组 ,治疗前后测定血脂以及用超声多普勒测定肱动脉血管内径、血流量以及反应性充血和含服硝酸甘油片后肱动脉内径和血流量变化。 2 8例经阿托伐他汀治疗 8周后血脂正常的患者停药 4周、8周 ,再次测定血脂以及肱动脉血管内径和血流量。结果　混合型高脂血症患者血管内皮依赖性舒张功能明显受损 (P <0 .0 0 1) ,而对硝酸甘油反应两组无差异 (P >0 .0 5 ) ,阿托伐他汀治疗 8周后血清TG、TC、LDL C、ApoB显著下降 ,对肱动脉内皮依赖性舒张功能较治疗前明显改善 (P <0 .0 0 1) ,停药后 4周、8周肱动脉血管内皮依赖性舒张功能明显下降 (P <0 .0 0 1) ,而治疗前后肱动脉内径以及对硝酸甘油的反应无变化。结论　阿托伐他汀治疗混合型高脂血症疗效明显 ,并显著改善肱动脉内皮依赖性舒张功能 ,这一作用源于其对内皮细胞的直接作用 ,可能独立于降脂作用之外

Effect of Atorvastatin on Endothelium-Dependent Diastolic Function of Patients with Mixed Hyperlipemia

Objective To observe the effect of short term treatment with atorvastatin on brachial endothelium dependent diastolic function of patients with mixed hyperlipemia.Method 60 patients with mixed hyperlipemia were treated with atorvastatin(10mg/d;po) for 8 weeks.60 healthy adults were as control group.Blood lipids were measured,and the baseline of brachial angiobore,blood flow and the changes of these at response to nitroglycerin and reactive hyperemia were measured by Dopple ultrasound before and after treatment.The above indices were measured again in 28 patients whose blood lipids was normal 4 and 8 weeks after treatment with atorvastatin that had stopped.Results Compared with the control group,the vascular endothelium dependent diastolic function of the patients with mixed hyperlipemia was obviously damaged( P <0.001),but there was no difference in response to nitroglycerin between the two groups( P >0.05).Serum TG,TC,LDL C and ApoB of the patients with mixed hyperlipemia obviously reduced after treatment with atorvastatin for 8 weeks,and the brachial artery vascular endothelium dependent diastolic function obviously improved( P <0.01),that of the patients with mixed hyperlipemia markedly reduced after stopping treatment with atorvastatin for 4 and 8 weeks( P <0.001),the brachial angiobore and the response to nitroglycerin were changeless before and after treatment.Conclusions Alorvastatin has obvious effect on the patients with mixed hyperlipemia,and it can obviously improved the brachial artery vascular endothelium dependent diastolic function.This role may due to direct effect on endothelium cells,but not related to lipid lowering action.