瑞舒伐他汀对高胆固醇血症患者颈动脉内膜中层厚度及血管内皮功能的影响

Effects of rosuvastatin on carotid intima-media thickness and endothelium-dependant flowing-mediated dilation in patients with hypercholesterolemia

目的:探讨瑞舒伐他汀对高胆固醇血症患者颈动脉内膜中层厚度及血管内皮功能的影响。方法:入选110例高胆固醇血症患者,随机分成瑞舒伐他汀治疗组36例、阿托伐他汀治疗组38例和饮食治疗组36例;入选30例健康者作为正常对照组。给予瑞舒伐他汀、阿托伐他汀治疗及饮食治疗8周,治疗前及治疗后分别检测颈动脉内膜中层厚度(IMT)及肱动脉血管内皮依赖性舒张功能(EDFMD)及血脂等。结果:与正常对照组相比,瑞舒伐他汀治疗组、阿托伐他汀治疗组和饮食治疗组IMT显著高于正常对照组(P<0.05),而EDFMD显著低于正常对照组(P<0.05)。与治疗前相比,瑞舒伐他汀治疗组和阿托伐他汀治疗组治疗8周后IMT显著降低(P均<0.05),而EDFMD显著升高(P均<0.05)。饮食治疗组治疗8周后IMT和EDFMD差异无显著性(P>0.05)。结论:瑞舒伐他汀与阿托伐他汀一样具有抗动脉粥样硬化和改善血管内皮功能作用,能够显著升高EDFMD,而显著降低IMT,可能是其改善心血管疾病预后的重要机制之一。

OBJECTIVE pendant flowing mediated di To investigate the effects of rosuvastatin on carotid Intima-media thickness and endothelium-de lation in patients with hypercholesterolernia. METHODS 110 hypercholesterolemic palients. Hy percholesterolemic patient s（n = 110） were randomly divided into three groups： the rosuvastatin group（n= 36）, the atorvastatin group（n=38） and the diet therapy group （n = 36） according to random digits table. The control group comprised 30 healthy volunteers. Those in the rosuvastatin group （n= 36） who were assigned to treatment with 10 mg·d ^-1 rosnvastatin and diet therapy for 8 weeks, likewise those in the atorwtstatin group （n = 38） who were assigned to treatment with 10 mg·d^-1 atorvastatin and diet therapy for 8 weeks, however those in the diet therapy group（n = 36） who were administered with＇diet therapy for 8 weeks merely. Study subjects were detected for carotid intima-media thickness （IMT） and endothelium-dependant flowing- mediated dilation（EDFMD） before treatment and after treatment. RESULTS Before treatment, the IMT in the patients of the rosuvastatin group, that of the atorvastatin group and that of the diet therapy group were significantly higher than that of healthy subjects（P = 0. 029） ,hbwever the EDFMD were significantly lower than that of healthy subjects（P = 0. 014）. After 8 weeks of rosuvastatin treatment and atorvastatin treatment, the IMT is decreased significantly（P〈0. 05）, but the EDFMD increased significantly（P〈0. 05）. After 8 weeks of diet treatment, the IMT and EDFMD did not change obviously（P〈0. 05）. CONCLUSION Atorvastatin can cure atherosclerosis and improve endothelial function, likewise rosuvastatin can do also in patients with Hypercholesterolemia. Rosuvastatin can increase the EDFMD, but decrease the IMT significantly, which may be one of the mechanisms of its improving cardiovascular disease prognosis .