阿托伐他汀对不稳定型心绞痛患者大动脉弹性的短期影响

Short-term effects of atorvastatin on arterial elasticity in patients with unstable angina

目的探讨阿托伐他汀对不稳定型心绞痛（UAP）患者大动脉弹性的短期影响。方法将72例UAP患者随机分为两组：对照组35例，给予常规治疗；观察组（37例）在上述常规治疗基础上加服阿托伐他汀10mg／d，每晚睡前服用1次。6个月后观察两组临床疗效及心脏意外事件，分别测定治疗前后的血脂、动脉脉搏波速度水平。结果治疗后观察组心绞痛发作及心电图改善均显著优于对照组（P均〈0．05）；观察组患者的胆固醇（TC）、甘油三酯（TG）、颈．股动脉脉搏波速度（cfPWV）、颈一桡动脉脉搏波速度（crPWV）、股、踝动脉脉搏波速度（faPWV）均显著低于对照组（t=10．036，2．4087，2．0199，2．1014，2．3097，P〈0．01或P〈0．05）；观察组患者的TC、TG、cfPWV、crPWV、lap—WV较治疗前显著降低（t=11．317，2．0863，3．1819，2．3364，2．6992，P〈0．01或P〈0．05）；对照组患者的TC、TG、of-PWV、crPWV、faPWV较治疗前无显著变化（t=1．1832，0．8204，1．0422，0．3096，0．3208，P均〉0．05）；6个月内观察组心血管事件发生率显著低于对照组（X2=5．7312，P〈0．05）。结论阿托伐他汀能显著降低不稳定型心绞痛患者脉搏波速度，改善大动脉弹性，降低血脂，提高临床疗效，减少心脏意外事件的发生率，安全性好。

Objective To investigate the short-term effect of atorvastatin on arterial elasticity in patients with unstable angina. Methods Seventy-two cases of UAP were randomly divided into two groups： the control group （35 patients） received conventional therapy; the observation group （37 cases） received atorvastatin （10 rag/d, once every night before bed） based on the conventional treatment. Clin- ical efficacy and cardiac accident were observed after 6 months, lipids （TC, TG） , arterial pulse wave velocity （efPWV, crPWV, faPWV） were measured before and after treatment. Results After treat- ment, angina pectoris and ECG in the observation group improved significantly better than that in the con- trol group （P all 〈 O. 05 ）. TC, TG, cfPWV, crPWV, faPWV in the observation group were significant- ly lower than that in the control group（ t = 10. 036, 2. 4087, 2. 0199, 2. 1014, 2. 3097, P 〈0. 01 or P 〈 0.05 ）. TC, TG, efPWV, crPWV, faPWV in the observation group were significantly lower than before treatment （t =11.317, 2.0863, 3. 1819, 2.3364, 2.6992, P 〈 0.01 or P 〈0.05）. There were no significant changes of TC, TG, cfPWV, crPWV, faPWV in the control group, eompared with before treatment （t = 1. 1832, 0. 8204, 1. 0422, 0. 3096, 0. 3208, P all 〉 0.05 ）. The incidence of car- diovascular events within 6 months in observation group was significantly lower than that in the control group （X2 = 5.7312, P 〈 0. 05 ）. Conclusions Atorvastatin can significantly reduce pulse wave velocity in patients with unstable angina and improve artery elasticity, lower blood lipids, improve the clinical ef- ficacy and reduce the incidence of cardiac accidents, and its safety is good.