瑞舒伐他汀对冠状动脉慢血流患者冠状动脉贮备功能和超敏C反应蛋白的影响

目的:探讨长期瑞舒伐他汀治疗对冠状动脉慢血流患者冠脉贮备功能(CFR)和超敏C反应蛋白(hsCRP)的影响。方法:选择冠状动脉造影正常但存在冠脉慢血流的患者48例,所有患者随机分为试药组和对照组,对照组(22例)予常规治疗,试药组(26例)在常规治疗基础上加用瑞舒伐他汀20 mg/d,治疗期为6个月。治疗前后测定两组患者的血脂,hsCRP,利用腺苷负荷超声记录左前降支远端血流频谱评评价CFR。结果:经过6个月瑞舒伐他汀的治疗后,试药组总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)较对照组明显下降,TC:(3.2±0.9)mmol/Lvs.(5.4±1.2)mmol/L,P<0.05;LDL-C:(2.1±0.7)mmol/L vs.(3.4±0.8)mmol/L,P<0.05]。hsCRP较对照组明显下降(2.1±1.4)mg/L vs.(3.7±2.1)mg/L,P<0.05]。试药组静息冠脉血流速度(bCFV)较对照组和治疗前显著下降(21±6)cm/s vs.(26±5)cm/s和(21±6)cm/s vs.(25±7)cm/s,P<0.05],而最大冠状动脉扩张状态hCFV较对照组和治疗前增加(71±9)cm/s vs.(56±8)cm/s和(71±9)cm/s vs.(56±10)cm/s,P<0.05],冠状动脉血流储备CFR较对照组和治疗前明显增加(3.2±0.6)cm/s vs.(2.1±0.5)cm/s和(3.2±0.6)cm/s vs.(2.2±0.4)cm/s,P<0.05)]。结论:冠状动脉慢血流患者经过瑞舒伐他汀治疗可以有效改善冠脉贮备功能。

Effects of rosuvastatin on coronary flow reserve and high-sensitivity C-reactive protein in patients with slow coronary flow

AIM:To investigate the effect of rosuvastatin on coronary flow reserve(CFR) and high-sensitivity C-reactive protein(hsCRP) in patients with slow coronary flow.METHODS:A total of 48 patients with slow coronary flow but normal coronary angiography were included in this study.Patients were divided into rosuvastatin group(20 mg/day for 6 months,n=26) and control group(non-statin,n=22) and blood cholesterol and hsCRP were measured.Doppler coronary flow velocity and Doppler reserve measurement of distal left anterior descending artery were recorded at rest and adenosine infusion-induced hyperemia state.CFR was calculated by the ratio of maximal hyperemia and baseline peak diastolic coronary flow velocity(hCFV and bCFV) before and after rosuvastatin treatment.RESULTS:After treatment for 6 months,total cholesterol(TC) and low-density lipoprotein cholesterol(LDL-C) levels in rosuvastatin group were significantly lower than those in control group TC:(3.2±0.9) mmol/L vs.(5.4±1.2) mmol/L,P<0.05;LDL-C:(2.1±0.7) mmol/L vs.(3.4±0.8) mmol/L,P<0.05].hsCRP in rosuvastatin group was significantly lower than in control group (2.1±1.4) mg/L vs.(3.7±2.1) mg/L,P<0.05].Compared with those in control group and rosuvastatin group before treatment,treatment for 6 months with rosuvastatin reduced bCFV (21±6)cm/sec vs.(26±5)cm/sec and(21±6)cm/sec vs.(25±7)cm/sec,P<0.05],increased hCFV (71±9) cm/sec vs.(56±8) cm/sec and(71±9) cm/sec vs.(56±10) cm/sec,P<0.05],and increased CFR (3.2±0.6) cm/sec vs.(2.1±0.5) cm/sec and(3.2±0.6) cm/sec vs.(2.2±0.4) cm/sec,P<0.05].CONCLUSION:Rosuvastatin may effectively improve coronary flow reserve and reduce hsCRP in patients with slow coronary flow.