辛伐他汀对高脂血症伴心肌缺血患者的临床疗效评价

目的 :探讨辛伐他汀调脂治疗对稳定劳力型心绞痛合并高胆固醇血症患者运动诱发心肌缺血的影响。方法 :选择运动试验阳性且血浆总胆固醇浓度增高的稳定劳力型心绞痛患者 90例 ,随机分为治疗组和对照组 ,治疗组给予辛伐他汀 12周 ,对照组仅给予饮食控制 ,治疗前后行心电图运动试验 ,比较两组运动试验结果。结果 :经治疗 12周后 ,治疗组总胆固醇 (TC)、甘油三酯 (TG)、低密度脂蛋白 (LDL C)均显著降低 ,高蜜度脂蛋白 (HDL C)显著升高 (P<0 .0 5 ) ,而对照组血脂各项指标的变化均无统计学意义。辛伐他汀组治疗后运动耐量显著提高 ,运动试验阳性率明显降低 ,ST段下移 1mm时间明显延长 ,ST段下移值显著减少 (P <0 .0 5 ) ,而对照组治疗前后各项指标的变化均无统计学意义。结论 :辛伐他汀在降低血脂的同时 ,还可明显减轻稳定劳力型心绞痛合并高胆固醇血症患者运动诱发的心肌缺血。

Clinical evaluation of efficacy of simvastatin on exercise-induced myocardial ischemia in patients with stable exertional angina pectoris and hypercholesterolemia

AIM: To evaluate the efficacy of simvastatin on exercise-induced myocardial ischemia in patients with stable exertional angina pectoris and hypercholesterolemia. METHODS: Ninety patients with stable exertional angina pectoris, positive rate of exercise test and hypercholesterolemia were randomly divided into two groups: the therapy group assigned to a 12-week treatment period either diet plus simvastatin (n=45); the control group with diet alone (n=45). All the patients underwent exercise testing before and after the treatment period. RESULTS: (1) Simvastatin-treated patients had a significant variation in total cholesterol, triglyccrides, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol after treatment (P< 0.05), whereas the control group had not. (2) After a 12-week treatment, only 8 patients (18%) of the therapy group had positive rates in exercise test, whereas 41 patients (91%)of the control group still had positive rates in exercise test. Exercise tolerance had significantly improved in the therapy group, the time to ST depression of 1.0 mm had prolonged and the severity of ST depression had reduced after treatment(P< 0.05). CONCLUSIONS: Besides the cholesterol-lowering effect, simvastatin can relieve exercise-induced myocardial ischemia in patients with stable exertional angina pectoris and hypercholesterolemia.