动脉僵硬度指数与冠脉狭窄程度的相关性研究

目的 探讨动态血压参数动脉僵硬度指数(AASI)与冠脉病变严重程度的关系.方法 对252例入选病例行冠脉造影术.冠状动脉病变损害程度采用Gensini法计分,所有病例均于术前监测24 h动态血压.记录参数:24 h收缩压(sBP)、24 h舒张压(DBP),以DBP为纵坐标,SBP为横坐标,求出斜率(β),动脉僵硬度指数=1-β.结果 高血压组较非高血压组冠心病患病率明显增高(P＜0.05).高血压组患者冠脉三支血管病变的患病率显著高于非高血压组(P＜0.05).冠脉狭窄组24 h动态血压监测,无论24 h、白昼还是夜间动脉僵硬度指数均显著高于冠脉正常组(P＜0.05).多因素Logistic回归分析结果显示:各动脉僵硬度指数与冠心病(CHD)冠脉狭窄程度的关系最为密切,且夜问动脉僵硬度指数较其他因素与CHD冠脉狭窄程度的关系更密切(P＜0.05).结论 动脉僵硬度指数是CHD冠脉狭窄发生发展的独立危险因素,动脉僵硬度指数与CHD冠昧狭窄程度的关系较为密切.     

老年慢性阻塞性肺疾病患者疾病严重程度与动脉僵硬度的关系

目的探讨老年慢性阻塞性肺疾病(COPD)患者疾病严重程度与动脉僵硬度的关系。方法选择年龄大于65岁的COPD患者153例,按照COPD全球倡议(GOLD)2011综合评估方法对患者进行病情评估并分组,症状少、低风险为A组,症状多、低风险为B组,症状少、高风险为C组,症状多、高风险为D组,同时根据年龄分为65~74岁组,75~84岁组,≥85岁组。以颈动脉-股动脉脉搏波传导速度(PWV)作为评价动脉僵硬度指标,分析不同组别COPD患者动脉僵硬度情况并分析相关因素。结果 D组年龄高于A组,D组患冠心病的比例高于A、B、C组(P0.05);各组间性别、吸烟情况、患高血压、糖尿病、高脂血症的比例无统计学差异;所有患者中有84例(54.9%)动脉僵硬度增高;A、B、C、D组患者PWV均值比较有统计学差异(P0.01);各组动脉僵硬度增高率A/B组、C/D组、A/C组、B/D组间比较,有统计学意义(P0.05),而B/C组比较无统计学差异(P0.05);在各年龄段中,D组患者PWV值及动脉僵硬度增高率高于A组患者(分别P0.01及P0.05);单因素分析结果显示,PWV14 m/s与PWV≤14m/s的患者疾病严重程度、年龄、吸烟史、氧分压、收缩压及脉压存在差异;疾病严重程度、年龄、氧分压及脉压进入回归方程,COPD患者疾病严重程度是动脉僵硬度增高的独立影响因素。结论老年COPD合并动脉僵硬增高患者构成比高,动脉僵硬度随COPD疾病严重程度而增高,老年COPD患者疾病严重程度是动脉僵硬度增高的独立影响因素。     

老年冠心病患者颈动脉硬度与冠状动脉造影的相关性研究

目的 检测老年冠心病患者的颈动脉硬度,探讨其与冠心病的相关性及在老年冠心病诊断中的价值.方法 选择35例老年冠心病患者进行冠状动脉(冠脉)造影,并根据其结果进行冠脉病变评分,同时检测颈动脉硬度;并与高血压组、高血脂组和健康老年组比较.结果 老年冠心病组的颈动脉紧张度(8.15±1.54)、动脉扩张性(0.34±0.07)及动脉僵硬度(640.51±150.98)与其他组比较,差异有统计学意义(P＜0.05或P＜0.01),且与冠脉病变积分呈明显相关(P＜0.05或P＜0.01).结论 老年冠心病患者的颈动脉硬度指标变化程度与冠脉狭窄程度相平行,可以作为预测冠心病的发生、发展及严重程度的一个指标.     

基质金属蛋白酶与动脉僵硬度的关系

动脉僵硬度增加为心脑血管系统发病和死亡的重要危险因素,降低动脉僵硬度对于降低心血管疾病的发生非常重要.无创性评价动脉僵硬度的一些指标如脉搏波传导速度(PWV)、反射波增强指数(AI)等均能良好反映个体动脉僵硬程度.基质金属蛋白酶(MMPs)是参与全身细胞外基质(ECM)降解的锌蛋白酶家族.临床研究资料表明,无论在健康人群中还是心血管疾病患者中,MMPs的表达及活性与动脉僵硬度增加均显著相关.MMPs可能成为降低动脉僵硬度和治疗心血管疾病的靶点之一.     

血清脂联素水平、动脉脉搏波传导速度与冠心病的相关性研究

目的 探讨血清脂联素(APN)水平、动脉脉搏波传导速度(PWV)与冠心病的相关性.方法 选取行冠状动脉造影的住院患者178例,其中确诊为急性冠状动脉综合征(ACS) 82例(ACS组),稳定性心绞痛者52例(SAP组),正常者44例(对照组),采用定量冠状动脉造影分析(QCA)法分析冠状动脉狭窄程度,酶联免疫吸附法测定APN水平,全自动动脉硬化测定仪测定PWV.结果 APN水平和PWV值在3组间比较差异均有统计学意义(P＜0.05);ACS组与SAP组患者PWV比较差异有统计学意义(P＜0.05).双支病变组和3支病变组的冠状动脉狭窄程度、APN水平及PWV值与对照组比较差异均有统计学意义(P＜0.05),冠状动脉狭窄程度、PWV值在单支病变组和双支病变组与3支病变组比较,差异均有统计学意义(P＜0.05).结论 冠心病患者APN水平随着病变程度加重而明显下降,而PWV明显升高.在冠心病患者中应用APN、PWV进行综合评估有助于预测疾病发展.     

脉搏波速度与冠状动脉病变的相关性研究

目的:应用脉搏波速度(pulse wave velocity,PWV)评价血管僵硬度,观察PWV与冠心病危险因素的相关性,及其对冠状动脉病变严重程度的预测价值. 方法:入选132例因胸痛疑诊冠心病而行冠脉造影的患者,其中男性68例,女性64例,平均年龄(66.4±10.0)岁.根据冠脉造影的结果,将患者分为冠状动脉正常组(Ⅰ组,n=32),冠状动脉病变单支组(Ⅱ组,n=33)、2支组(Ⅲ组,n=27)和3支组(Ⅳ组,n=40);同时有创测量中心动脉收缩压(CSBP)、舒张压(CDBP)及脉压(CPP).用欧姆龙动脉硬化检测仪测量患者臂踝PWV(baPWV).检测体质指数、血脂、颈总动脉内膜中层厚度、血清肌酐、左室质量指数等冠心病危险因素. 结果:逐步多变量回归分析显示,年龄(β =0.46,P＜0.01)和CSBP(β=0.19,P=0.013)与baPWV明显相关.baPWV比较:Ⅰ组与Ⅱ组无统计学差异(P=0.83);Ⅲ组、Ⅳ组较Ⅰ组和Ⅱ组明显升高(P＜0.05);Ⅲ组与Ⅳ组无统计学差异(P=0.47). 结论:年龄和CSBP是影响baPWV的两个独立危险因素.baPWV与冠状动脉病变严重程度明显相关,可以作为无创、简便、可重复的预测冠状动脉病变程度的一个重要指标.     

基质金属蛋白酶与动脉僵硬度的关系

动脉僵硬度增加为心脑血管系统发病和死亡的重要危险因素,降低动脉僵硬度对于降低心血管疾病的发生非常重要。无创性评价动脉僵硬度的一些指标如脉搏波传导速度(PWV)、反射波增强指数(AI)等均能良好反映个体动脉僵硬程度。基质金属蛋白酶(MMPs)是参与全身细胞外基质(ECM)降解的锌蛋白酶家族。临床研究资料表明,无论在健康人群中还是心血管疾病患者中,MMPs的表达及活性与动脉僵硬度增加均显著相关。MMPs可能成为降低动脉僵硬度和治疗心血管疾病的靶点之一。     

大动脉僵硬度与冠心病相关性研究

目的探讨颈-股动脉脉搏传导速度(C-F PWV),分析大动脉僵硬度和冠心病的相关性。方法408例行冠状动脉造影的患者,男313例,女95例。均采用Complior SP测量系统测量C-F PWV。记录血流动力学指标和心血管危险因素。冠状动脉病变的严重程度用冠状动脉病变的血管支数表示,比较不同严重程度冠心病患者的C-F PWV值,同时对C-F PWV与冠脉复杂病变的相关性进行评估。结果冠心病组年龄明显大于对照组[分别为(65.6±9.5)岁与(59.8±10.2)岁,P<0.01]。C-F PWV在校正了年龄、性别、高血压、高血脂和糖尿病等因素后经Logistic回归分析后,仍与冠心病的存在显著相关,分别为(10.3±1.79)与(12.8±3.1)m/s,P<0.01。C-F PWV值的升高和冠脉病变的严重程度相关(P<0.01),同时伴有更多的复杂病变,如完全闭塞病变,弥漫性病变和钙化病变。结论C-F PWV是一个判断冠心病存在及其严重程度的独立预测指标。     

应用超声检查评价高血压患者血管僵硬度与心功能的关系

目的 应用超声检查、评价高血压患者动脉僵硬度和心功能的关系.方法 分别检测、计算高血压组(167例)与对照组(165例)的心功能和颈动脉血管僵硬度参数,并进行两组间比较.结果 二尖瓣口舒张早期血流速度峰值(E峰)与左心室后壁二尖瓣环舒张早期速度峰值(e峰)比值(E/e)、Tei指数高血压组分别为(10.92±3.14)和(0.58±0.13),对照组分别为(7.70±1.56)和(0.45±0.09),两组差异有统计学意义(均P＜0.05);射血分数两组间差异无统计学意义(P＞0.05).血管僵硬度参数β、压力应变弹性系数、脉搏波传导速度(PWVβ)和动脉顺应性高血压组分别为(11.0±5.2)、(172.6±83.8)kPa、(7.8±1.6)m/s和(0.6±0.2)mm2/kPa.对照组分别为(7.5±3.0)、(97.1±45.4)kPa、(5.9±1.3)m/s和(0.8±0.3)mm2/kPa,两组差异有统计学意义(均P＜0.05).E/e与压力应变弹性系数和PWVβ呈正相关(γ分别为0.316和0.296,P＜0.05),Tei指数与压力应变弹性系数、增大指数和PWVβ呈正相关(γ分别为0.278、0.300和0.323,P＜0.05或P＜0.01);射血分数与血管僵硬度参数无相关性.结论 高血压引起动脉僵硬度增高,心功能障碍;动脉硬化可作为早期心功能障碍预测指标之一.     

肱动脉内皮功能对老年冠心病患者的预测价值

目的 探讨肱动脉内皮功能对老年冠心病患者的预测价值.方法 测定98例冠心病患者及37例对照者肱动脉内皮依赖血管舒张功能(FMD)及非内皮依赖血管舒张功能(NMD),根据冠脉造影结果将患者分为冠脉病变＜50%,50%～75%,＞75%病变组和冠脉病变0、1、2、3支病变组,以比较老年冠心病患者冠脉病变程度、范围与肱动脉F...     

多种大动脉僵硬度指标的联合应用对冠心病预测价值的研究

目的探讨多种大动脉僵硬度无创检测指标对冠心病发病的预测作用。方法选择205例具有冠心病危险因素的住院患者,根据冠状动脉造影结果分为冠心病组(136例)和对照组(69例)。完成脉搏波传导速度(PWV)、大小动脉弹性指数、脉搏波分析和颈总动脉超声4项检测。并采用多元逐步logistic回归分析各因素与冠心病发病风险的关系;ROC曲线评估无创检测的敏感性和特异性。结果与对照组比较,冠心病组平均年龄、男性比例、糖尿病患者比例、血清肌酐、受试当天左侧肱动脉收缩压和肱动脉脉压均增高(P0.05),PWV、增强压(AP)、中心动脉脉压(CPP)、颈总动脉内膜中层厚度(C-IMT)和颈总动脉内径均值明显升高(P0.05),两组大小动脉弹性指数、反射波增强指数、CPP/外周脉压(PP)均值无显著差异。在校正了年龄、性别、身高和受试时心率后,两组AP、CPP、CPP/PP、C-IMT均值明显增高(P0.05)。结论多种大动脉僵硬度指标与冠心病发病独立相关。logistic回归模型是较为理想的冠心病筛查工具,具有一定的临床实用价值。     

Pulse Wave Velocity as a Marker of Severity of Coronary Artery Disease

To determine whether pulse wave velocity (PWV) as a measure of arterial stiffness is a marker of coronary artery diseases (CAD), the authors did a cross-sectional study in 92 patients undergoing coronary angiography for suspected CAD. Arterial stiffness was assessed through recording PWV from the left carotid–right femoral arteries using an automated machine. The mean PWV was higher in patients with CAD than in those without CAD (11.13±0.91 vs 8.14±1.25 m/sec; P< .001). When the severity of CAD was expressed as 1-, 2-, and multiple-vessel disease, there was a significant association between the severity of CAD and PWV. PWV differed significantly with different categorical severity of CAD even when age and total cholesterol were controlled for. In a univariable analysis, PWV was higher with higher systolic blood pressure (P< .004). The authors conclude that arterial stiffness measured through PWV is an independent and complementary cardiovascular risk marker.     

冠心病合并糖尿病患者血清超敏C反应蛋白水平与冠脉病变特点关系分析

目的探讨冠心病合并2型糖尿病患者冠状动脉病变与血清超敏C反应蛋白（hs—CRP）的相关性。方法经冠状动脉造影确诊冠心病患者，并根据既往或入院后OGTT试验结果分为合并2型糖尿病组和非糖尿病组，检测其hs-CRP、血糖、血脂水平及平均动脉压，并对合并2型糖尿病组冠状动脉病变程度与hs—CRP、血糖、血脂水平、平均动脉压、性别及吸烟史等因素作Logistic回归分析。结果冠心病合并2型糖尿病组hs—CRP水平及冠脉病变程度明显高于非糖尿病组（均P〈0.05）。Spearman秩相关分析表明，冠心病合并2型糖尿病组及非糖尿病组hs-CRP水平与冠状动脉病变支数均呈正相关（无糖尿病组r=0．827，P〈0．01；合并糖尿病组r=0．897，P〈0．01）。Logistic回归分析表明，年龄、吸烟史、hs—CRP、血糖、低密度脂蛋白及总胆固醇等是冠心病合并2型糖尿病患者冠脉病变严重程度的危险因素（均P〈0．05），且hs—CRP是其中最重要的危险因素；而性别、甘油三酯、高密度脂蛋白及平均动脉压不是冠心病合并2型糖尿病患者冠脉病变严重程度的危险因素（均P〉0．05）。结论冠心病合并2型糖尿病组炎症反应水平明显强于非糖尿病组，且患者炎症反应水平与冠脉损伤正相关；糖尿病可能通过炎症反应促进冠心病的发生及发展。监测冠心病合并2型糖尿病患者血清hs—CRP水平，对预测其冠状动脉粥样硬化病变的严重程度有一定意义。     

原发性高血压并发心脑血管疾病患者的危险因素分析

目的：研究原发性高血压（EH）伴冠心病和／或脑血管病患者的临床特点，分析其相关的危险因素。方法：对55例EH伴冠心病和／或脑血管病患者，进行动脉硬化指数（ASI）测定，并检测患者的血尿酸、血糖、血脂、肌酐、尿素氮等血液生化指标及一般情况。另选不伴有冠心病、脑血管病的高血压患者63例作为对照。结果：与单纯高血压对照组比较，EH伴冠心病和／或脑血管的年龄大、病史时间长，ASI、脉压、血尿素氮水平明显升高（均P〈0.01）；收缩压、血尿酸、总胆固醇、肌酐水平也升高（均P〈0．05）；而舒张压（P〈0．01），心率（P〈0．05）却较低。多因素logistic回归分析显示：EH并发心脑血管疾病的相关危险因素有脉压、血肌酐、年龄（OR=1．204，1．120，1．099,P=0．028，0．045，0．039）；而血尿酸是负相关因素（OR=0．974，P=0．022）。结论：脉压、血肌酐水平和年龄可能是高血压患者并发心脑血管疾病的危险因素；血尿酸可能是一种保护因素。     

肾功能正常冠心病患者及高危人群中甲状旁腺激素与大动脉僵硬度关系的研究

目的探讨肾功能正常冠心病患者及冠心病高危人群血清甲状旁腺激素(PTH)与大动脉僵硬度的关系。方法选取2007年8月至12月上海交通大学医学院附属瑞金医院心脏科77例具有冠心病危险因素的住院患者,根据无创中心动脉脉压(CPP)是否大于40mmHg将病例分为大动脉僵硬度增高组(35例)和对照组(42例)。所有患者测定全段甲状旁腺激素(iPTH)、钙、磷、高敏C-反应蛋白(hsCRP)等指标,并行冠状动脉造影。结果(1)与对照组比较,大动脉僵硬度增高组平均年龄大、血尿酸增高;入选患者中44例确诊为冠心病,大动脉僵硬度增高组冠心病患者(23例)血清iPTH较对照组(21例)显著增高(P0.05)。(2)血清iPTH与CPP呈正相关(r=0.262,P=0.022)。(3)多因素Logistic回归分析表明,在调整了年龄、BMI、hsCRP和男性4个因素后,血清iPTH(OR=1.065,95%CI:1.005～1.127,P=0.032)是大动脉僵硬度增高(CPP40mmHg)的独立危险因素。结论大动脉僵硬度增高的肾功能正常冠心病患者血清PTH增高。血清PTH与大动脉僵硬度呈正相关,并且是大动脉僵硬度增高(CPP40mmHg)的独立危险因素。     

高血压病患者动态血压与动脉顺应性的相关性研究

目的:探讨高血压病患者动脉顺应性的变化,及其与动态血压监测(ABPM)各指标间的相互关系。方法:对262例高血压病患者和104例正常人进行动态血压监测(ABPM)和脉搏波速度(PWV)测定。结果:高血压组的颈动脉-桡动脉(G-R)PWV、颈动脉-股动脉(C-F)PWV,24 h、白昼及夜间平均血压,平均脉压,心率,血压负荷均显著高于正常对照组(P<0.05~<0.01)。C-F PWV及C-R PWV与24 h、白昼及夜间平均血压,心率,血压负荷均呈显著正相关(r=0.108~0.406,P<0.05~<0.001)。C-F PWV比C-R PWV与平均收缩压和收缩压负荷的相关性更强。C-F PWV与动态脉压、年龄显著正相关(r=0.205~0.406,P<0.001)。结论:动脉顺应性减退是高血压的重要改变,大动脉顺应性与动态脉压、收缩压和年龄的关系更为密切。     

Peroxisome proliferator-activated receptor gamma agonist improves arterial stiffness in patients with type 2 diabetes mellitus and coronary artery disease

Arterial stiffness is an independent risk factor for cardiovascular events in diabetic patients, and it can be assessed by measuring pulse wave velocity (PWV). We investigated the degree of arterial stiffness in diabetic patients with coronary artery disease (CAD) and the effect of the proliferator-activated receptor gamma (PPAR-gamma) agonist rosiglitazone on arterial stiffness in the potential mechanism of anti-arteriosclerosis in patients with type 2 diabetes mellitus and CAD. The 123 participants were divided into 3 groups: healthy controls (n = 36), diabetic patients (n = 41), and diabetic patients with CAD (n = 46). Forty-six diabetic patients with CAD were randomly divided into 2 groups: untreated diabetic patients with CAD and diabetic patients with CAD treated with 4 mg/d of rosiglitazone (n = 25) for 12 weeks. Pulse wave velocity was measured before treatment and at 12-week follow-up. Baseline PWV was significantly higher in patients with diabetes, diabetes and CAD, and diabetes and CAD with treatment as compared with the healthy control group (1,633 +/- 37.3, 1,669 +/- 53.8, 1,615 +/- 44.4, and 1,360 +/- 39.9 cm/s, respectively, P < .001). Pulse wave velocity in the rosiglitazone-treated group was significantly reduced, from 1,615 +/- 44.4 to 1,525 +/- 43.1 cm/s, after 12-week treatment, Furthermore, PWV was significantly decreased in the rosiglitazone-treated group compared with untreated group after 12 weeks (1525 +/- 43.1 and 1,670 +/- 41.3 cm/s, respectively). Pulse wave velocity in the untreated group did not differ from baseline levels after 12 weeks. In addition, plasma C-reactive protein level was decreased significantly in the rosiglitazone-treated group compared with values at baseline and for the untreated group after 12 weeks (0.73 +/- 0.09, 1.71 +/- 0.24, and 1.33 +/- 0.29 mg/L, respectively). Plasma level of monocyte chemoattractant protein 1 was decreased in the rosiglitazone group compared with the level at baseline (392 +/- 42 and 273 +/- 40 pg/mL, respectively). Moreover, the decrease in PWV was associated linearly both with improved homeostasis model assessment of insulin resistance and with decreased C-reactive protein level after PPAR-gamma agonist treatment. In conclusion, PPAR-gamma agonist rosiglitazone treatment may significantly decrease arterial stiffness in diabetic patients with CAD. Proliferator-activated receptor gamma agonists may play an important role in protecting against arteriosclerosis by normalizing the metabolic disorders and depressing chronic inflammation of the vascular system in patients with type 2 diabetes mellitus and serious vascular disease.     

Assessment of arterial stiffness index as a clinical parameter for atherosclerotic coronary artery disease.

BACKGROUND: The aim of the present study was to assess the feasibility and usefulness of the arterial stiffness index (ASI) measured non-invasively by computerized oscillometry and by comparing it with the pulse wave velocity (PWV). METHODS AND RESULTS: The study group comprised 60 consutive patients who underwent coronary angiography and whose aorto-femoral PWV were obtained with a Judkins catheter. The ASI was obtained using Cardio Vision MS-2000 (IMDP, Las Vegas, NV, USA): (i) baseline (ASI-B); (ii) hyperemia induced by compression of the arm with cuff pressure for 5 min (ASI-H); and (iii) sublingual nitroglycerin (ASI-N). In total, 34 patients had significant coronary artery disease (CAD). The PWV and all ASI were higher in patients with CAD than in those without CAD (ASI-B, 85.9+/-57.8 vs 48.2+/-24.5, p=0.001; ASI-H, 98.1+/-49.8 vs 48.1+/-21.3, p<0.01; ASI-N, 66.7+/-55.7 vs 33.2+/-27.9, p=0.002). However, only ASI-B and ASI-H were positively correlated to the PWV (ASI-B, r=0.27, p=0.03; ASI-H, r=0.49, p=0.001; ASI-N, r=0.19, p=0.16). The ASI was increased after hyperemia in patients with CAD (ASI-H, 85.9+/-57.8 to 98.1+/-49.8, p=0.01), but not in patients without CAD (ASI-H, 48.2+/-24.5 to 48.1+/-21.3, p>0.01). After adjusting their age, only ASI-H was correlated to the presence of CAD (r=0.33, p<0.01). CONCLUSIONS: It is feasible and useful to use the ASI for detection of atherosclerotic coronary disease. The findings of ASI-H suggests that in addition to stiffening of the arterial wall itself, the impairment of flow mediated vasodilation, because of endothelial dysfunction, further increases the arterial stiffness.     

不同诊断标准下腹膜透析患者代谢综合征与大动脉僵硬度的关系

目的 对腹膜透析患者在不同诊断标准下诊断的代谢综合征与大动脉僵硬度的关系进行研究,从而确定一个最适合腹膜透析患者的标准,同时对影响大动脉僵硬度的因素进行分析.方法 选取稳定透析的持续不卧床腹膜透析患者155例,测量颈股动脉脉搏波速度作为大动脉僵硬度的评价指标,用WHO 1999、IDF 2007和ATPⅢ2001三个标准分别诊断代谢综合征,比较不同标准下代谢综合征组与非代谢综合征组脉搏波速度有无差别,并对脉搏波速度的相关因素进行分析.结果 用WHO 1999、IDF 2007和ATPⅢ2001标准诊断的合并代谢综合征的持续不卧床腹膜透析患者均比无代谢综合征患者有较高的脉搏波速度(P<0.05).脉搏波速度与持续不卧床腹膜透析患者的年龄、腰围、收缩压及血糖呈正相关(P<0.05或P<0.01),与血高密度脂蛋白胆固醇呈负相关(P<0.05),它们都是脉搏波速度的独立影响因素.结论 无论用WHO 1999、IDF 2007和ATPⅢ2001中任何一个代谢综合征标准,合并代谢综合征的持续不卧床腹膜透析患者大动脉僵硬度均较非代谢综合征患者增加.年龄和代谢综合征中多数因子均是脉搏波速度的独立影响因素.经多方考虑,我们推荐在持续不卧床腹膜透析患者用ATPⅢ标准诊断代谢综合征.     

Fluvastatin improves arterial stiffness in patients with coronary artery disease and hyperlipidemia: a 5-year follow-up study.

BACKGROUND: The present study was designed to test the hypothesis that fluvastatin might improve arterial stiffness, as assessed with pulse wave velocity (PWV), in patients with coronary artery disease (CAD) and hyperlipidemia over the long term. METHODS AND RESULTS: Ninety-three patients were randomly assigned to either fluvastatin (group A, n=50) or bezafibrate (group B, n=43) and followed for 5 years. There was no difference in the clinical findings between the 2 groups. In group A, there was a progressive reduction in the brachial-ankle PWV along with a decrease in serum low-density lipoprotein-cholesterol (LDL-C) and C-reactive protein (CRP) by 12 months after fluvastatin, and the improvement was maintained until 5 years after treatment. In group B, despite identical lowering of the serum lipid, PWV was progressively increased. In group A, the percentage change in PWV correlated significantly with that of the serum CRP (r=0.49, p<0.001), but not with that of the serum LDL-C after treatment. CONCLUSIONS: The beneficial vascular effects of fluvastatin persisted for a long period in patients with CAD and hyperlipidemia. Its anti-inflammatory action might contribute to the favorable effects on arterial stiffness.