阿托伐他汀对冠心病患者的血管舒张功能的影响

目的观察阿托伐他汀对冠心病患者血管舒张功能的作用。方法将入选60例冠心病并高胆固醇血症患者随机分为阿托伐他汀治疗组(A组)和对照组(B组)。分别测定血清胆固醇、三酰甘油、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇。并应用高分辨率超声技术,检测治疗前、后两组肱动脉血流介导和硝酸甘油介导的舒张功能。结果治疗前,冠心病并高胆固醇血症患者肱动脉血流介导和硝酸甘油介导的舒张功能均低于健康对照组(P<0.01)。经阿托伐他汀治疗6个月后A组血浆总胆固醇、三酰甘油和低密度脂蛋白胆固醇显著降低(P<0.01),高密度脂蛋白胆固醇显著升高(P<0.01)。随着血脂的改善,肱动脉内皮依赖性血管舒张功能显著提高(P<0.01),但硝酸甘油介导的血管舒张功能未见改善(P>0.05)。结论冠心病并高胆固醇血症患者存在内皮依赖性血管舒张功能障碍,经阿托伐他汀调脂治疗后,受损的内皮依赖性血管舒张功能得到明显改善。

Effect of atorvastatin on endothelium dependent vasodilation in patients with coronary heart disease and hyper-choleslerolemia

Objective To investigate influence of atorvastatin on endothelium-dependent vasodilation in patients with coronary heart disease(CHD)and hypercholesterolemia.Methods 60 CHD patients with hypercholesterolemia were randomly divided into atorvastatin group(A group,10mg/d of atorvastatin for 6 months,n=30)and control group(B group,not lipid-lowering drugs,n=30).Before and after six months,blood lipids were measured,the flow-mediated dilatation and glyceryl trinitrate(GTN)-induced vasodilation of brachial artery were detected by high-resolution-ultrasound technique.Results Both flow-mediated dilatation and GTN-induced vasodilation of brachial artery in CHD patients with hypercholesterolemia were reduced compared with those of healthy group(n=30).After cholesterol-lowing therapy with atorvastatin for 6 months,serum total cholesterol,low density lipoprotein cholesterol and triglycerides were significantly lowered(P<0.01).Flow-mediated vasodilations improved significantly after atorvastatin therapy.The vasodilation response on nitroglycerin had no significantly change(P>0.05).Conclusion Endothelium-dependent vasodilalion was impaired in CHD patients with hypercholesterolemia,and cholesterol-lowering therapy with atorvastatin may improve impaired endothelium dependent vasdilation.