普伐他汀降脂治疗对冠心病血管内皮舒张功能的影响

Effect of cholesterol-lowering therapy with pravastatin on brachial endothelium-dependent relaxation

目的 :研究普伐他汀对冠心病高胆固醇血症患者血管内皮依赖性舒张功能的影响。方法 :采用高分辨超声技术 ,对 70例冠心病高胆固醇血症患者普伐他汀降脂前后和 70例正常对照者的血管内皮依赖性舒张功能进行检测。结果 :高胆固醇血症组肱动脉血流介导性舒张较正常对照组明显减弱 ((3.5± 2 .8) %和 (14 .5± 3.4 ) % ,P<0 .0 0 1) ,而 2组对硝酸甘油的反应差异无统计学意义 ((2 0 .5± 7.2 ) %和 (2 2 .9± 4 .3) % ,P >0 .0 5 )。 70例冠心病高胆固醇血症患者服用普伐他汀 10mg治疗 (3.8± 0 .8)个月后 ,血浆总胆固醇从 (6 .31± 0 .70 )mmol/L降至 (5 .0 6±0 .6 3)mmol/L ,同时肱动脉内皮依赖性舒张较治疗前明显改善 ((10 .0± 3.2 ) %和 (3.5± 2 .8) % ,P <0 .0 0 1) ,而治疗前后肱动脉对硝酸甘油的反应无明显改变。结论 :冠心病高胆固醇血症患者存在血管内皮依赖性舒张功能障碍 ;经普伐他汀降胆固醇治疗后 。

Aim: To investigate the effect of cholesterol-lowering therapy with pravastatin on endothelium-dependent relaxing function in patients with hypercholesterolemia.Methods: With high-resolution ultra-sound, endothelium-dependent relaxing function of 70 cases of hypercholesterolemia and 70 controls were measured.Results: In patients with primary hypercholes terolemia,flow-mediated dilatation in arteries significantly reduced compared with control group((3.5±2.8)% vs (14.5±3.4)%,P<0.001).However,there was no significant difference in response to nitroglycerin between the two groups((20.5±7.2)% vs (22.9±4.3)%,P>0.05).Seventy hypercholesterolemic patients were studied before and after cholesterol-lowering therapy with pravastatin(an inhibitor of HMC-COA reductase) for (3.8±0.8) months,by which serum cholesterol decreased from (6.31±0.70) mmol/L to (5.06±0.63) mmol/L(P<0.001).Flow-mediated vasodilations were significant improved after simvastatin therapy than that of before therapy ((10.0±3.2)% vs (3.5±2.8)%, P<0.001).The vasodilation response to niroglycerin has no significant change after cholesterol-lowering therapy.Conclusion: Endothelium-dependent vasodilation was impaired in patients with primary hypercholeste rolemia,and cholesterol-lowering therapy with pravastatin may improve impaired endothelium-dependent vasodilation.