辛伐他汀对冠状动脉造影病变的影响

目的：评价辛伐他汀治疗对冠状动脉造影病变的影响。方法：７３例冠心病患，无论血清总胆固醇水平升高与否，随机分为辛伐他汀组（３９例）和空白对照组（３４例）。平均治疗１年后重复冠状动脉造影，采用计算机定量测定系统评价冠状动脉病变狭窄程度的变化，同时随访患的临床情况。结果：辛伐他汀组患在接受降脂治疗后血清总胆固醇降低１５．４％，低密度脂蛋白－胆固醇下降２５．３％，高密度脂蛋白－胆固醇增加１１．５％。辛伐他汀组２０．７％的病变进展，对照组４１．９％的病变进展（Ｐ〈０．０５）。辛伐他汀治疗使冠状动脉病变进展的危险性下降５０．６％。辛伐他汀组２０．５％的病人病情恶化，对照组５５．９％的病人病情恶化（Ｐ〈０．０５）。辛伐他汀治疗使恶化病例减少６３．３％。心脏事件（急性心肌梗死、血管重建和死亡）辛伐他汀组１２例（３０．７％

Effect of simvastatin on coronary atheroma

Objective To evaluate the effects of simvastatin on coronary atheroma. Methods Patients were randomized to receive either simvastatin or not after coronary angiography or successful PTCA. Coronary angiography was repeated and clinical follow up was completed 1 year later. Results In simvastatin group, patients had a 15 4% reduction in serum cholesterol, 25 3% reduction in low density lipoprotein cholesterol, and 11 5% increase in high density lipoprotein cholesterol. 20 7% lesion in simvastatin group and 41 9% lesion in control group progressed ( P < 0 05). On the per patient basis angiographic progression occurred less often in the simvastatin group (20 5% vs 55 9%, P < 0 05). There were no difference in restenosis of PTCA and stent. In simvastatin group less patients had unstable angina. Conclusion The trial showed that simvastatin given daily over 1 year can reduce hyperlipidaemia and slow progression of coronary atheroma and improve the clinical outcomes.