阿托伐他汀对长期吸烟者内皮功能的改善作用

Effect of atorvastatin on vascular endothelium function in long-term smokers

目的探讨阿托伐他汀对长期吸烟者血管内皮功能改善及炎症因子的影响。方法长期吸烟者264例,随机分为两组;治疗组接受12周阿托伐他汀(20mg/d),对照组服用安慰剂,应用高分辨超声测定肱动脉血管内皮依赖性舒张功能及非内皮依赖性血管舒张功能,以及检测受试者外周血清中一氧化氮(nitric oxide,NO)、内皮素1(endothelin,ET)、C反应蛋白(C reactive protein,CRP)水平,观察受试者内皮功能改善情况。结果治疗组服用12周阿托伐他汀治疗后血管内皮依赖性舒张功能及非内皮依赖性血管舒张功能均有明显改善,与治疗前比较,NO水平明显升高,(78.7±14.32)μmol/L vs(67.2±13.02)μmol/L;ET、CRP水平明显下降,ET(44.6±8.54)ng/L vs(86.1±6.81)ng/L、CRP(2.84±3.12)mg/L vs(5.80±5.29)mg/L,差异有统计学意义(P<0.05)。治疗组血流介导的血管舒张反应(FMD)(11.48±5.35)%vs(7.76±3.87)%及硝酸甘油介导的血管舒张反应(NMD)(10.80±3.12)%vs(7.80±2.29)%较治疗前有明显改善。结论阿托伐他汀通过抗氧化应激对长期吸烟者血管内皮功能有明显的改善作用,从而保护其血管内皮功能。

Objective To investigate the effect of atorvastatin on endothelium-dependent vasodilatation function and inflammation factors in long term smokers.Methods 264 long-term smokers were divided randomly into atorvastatin group（20 mg/d） and control group（placebo） for 12 weeks.A non-invasive high-resolution ultrasound was used to detect the dilation changes of brachial arteries during reactive hyperemia and after sublingual nitroglycerin,and blood endothelin-1（ET-1）,blood C-reaction protein（CRP） and nitric oxide（NO） level were measured before and 12 weeks after treatment.Results At 12 weeks after atorvastatin treatment,the levels of ET-1 and CRP decreased,（44.6±8.54） ng/L vs（86.1±6.81） ng/L,（2.84±3.12） mg/L vs（5.80±5.29） mg/L（P0.05） and blood NO leve1 increased more obvously than those in control group,（78.70±14.32） μmol/L vs（67.20±13.02） μmol/L.Flow-mediated dilation（FMD） and nitroglycerin-mediated dilation of brachial arteries（NMD） in atorvastatin group were much improved compared with before treatment（11.48±5.35）% vs（7.76±3.87）%,（10.80±3.12）% vs（7.80±2.29）%.Conclusion Additional atorvastatin may improve vascular endothelial function on long-term smokers by anti-oxidative stress.