普伐他汀对稳定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

The effect of pravastatin on myocardial ischemia induced by exercise testing in patients with stable exertional angina pectoris and hypercholesterolemia

目的探讨普伐他汀调脂治疗对稳定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水平增高的稳定型心绞痛患者114例,随机分为治疗组和对照组。结果(1)经12周治疗后,治疗组血TC、TG、LDL-C均显著降低,HDL-C显著升高(P<0.05),而对照组血脂各项指标的变化均无统计学意义;(2)普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,至ST段下移1mm时间明显延长,ST段下移值显著减少(P<0.05),而对照组治疗前后各项指标的变化均无统计学意义。结论普伐他汀治疗在降低血脂的同时,还可明显减轻稳定型心绞痛合并高胆固醇血症患者运动诱发的心肌缺血。

Objective To investigate the effect of pravastatin on myocardial isehemia induced by exercise testing in patients with stable exertional angina pectoris and hypercholesterolemia. Methods All the patients with stable exertional angina pectoris, positive exercise test and hypercholesterolemia were randomly assigned to 12-week treatment period either diet plus pravastatin（n=58） or diet alone（n=56）. All the patients underwent exercise testing before and after the treatment period. Results （1） Pravastatin- treated patients had a significant variation in total cholesterol, triglyeerides, high- density lipoprotein cholesterol and low- density lipoprotein cholesterol after treatment （P〈0.05）, whereas the diet- alone group had not; （2）After 12 weeks of treatment, only 15 patients （26%） in the pravastatin group had a positive exercise test, whereas 49 patients （88%） of the diet group still had positive tests （P〈0.05）. After treatment, the patients in the pravastatin group had significantly improved exercise tolerance, prolonged time to ST depression of 1.0 mm and reduced the severity of ST depression. Conclusion Besides the cholesterol-lowering effect, pravastatin can reduce exercise-induced myocardial isehemia in patients with stable exertional angina pectoris and hypereholesterolemia.