40mg与10mg阿托伐他汀对冠心病患者外周血循环内皮微颗粒及血管内皮功能的影响比较

目的:比较40 mg与10 mg阿托伐他汀对冠状动脉粥样硬化性心脏病(冠心病)患者外周血循环内皮微颗粒(cEMPs)及血管内皮功能的影响。方法:选择100例冠心病患者随机分为阿托伐他汀10 mg/d治疗组及40 mg/d治疗组各50例,两组均每日用药1次,疗程均为1年,另收集同期门诊健康体检者非冠心病100名为对照组。研究期为1年,在研究初始及结束时分别检测所有研究对象的肌酸激酶、肝功能、血脂、外周血cEMPs及肱动脉对反应性充血的内皮依赖血管扩张反应(FMD),记录两研究组患者阿托伐他汀不良反应的发生率。结果:研究结束时,与10 mg阿托伐他汀治疗组比较,40 mg阿托伐他汀治疗组患者的血浆总胆固醇、LDL-C及外周血cEMPs水平明显降低,FMD明显升高,比较差异均有统计学意义(P均<0.05),研究期间两组均无患者发生药物性肝炎及横纹肌溶解,结束时两组血清肌酸激酶及ALT水平比较差异无统计学意义(P>0.05)。结论:与10 mg阿托伐他汀比较,40 mg阿托伐他汀更能降低冠心病患者的血脂水平,改善患者的血管内皮功能,且未增加药物不良反应的发生率。

Effects of 40 mg and 10 mg atorvastatin on circulating endothelial-derived microparticles and vascular endothelial function in patients with coronary heart disease

Objective： To investigate the different effects of 40 mg and 10 mg atorvastatin on circulating endo- thelial-derived microparticles （cEMPs） and vascular endothelial function in patients with coronary heart disease （CHD）. Methods： One hundred patients with CHD and 100 healthy volunteers were recruited, and patients with CHD were randomly divided into two groups ： 10 mg atorvastatin group and 40 mg atorvastatin group （ n = 50, once daily, for one year）. All subjects were followed up for 1 year. The levels of serum lipids, cEMPs and flow mediated dilation （FMD） of brachial artery were assessed. The adverse reactions were recorded. Results： At the end of this study, the levels of total cholesterol, LDL and cEMPs were significantly alleviated, while FMD was significantly increased, in 40 mg atorvastatin group in comparison with those in 10 mg atorvastatin group （P 〈0. 05）. No adverse event was reported. Conclusion： In patients with CHD, 40 mg atorvastatin effectively alleviates the levels of lipids, and improves vascular endothelial function in contrast to 10 mg atorvastatin.