高脂血症患者动脉弹性和内皮功能变化及阿托伐他汀的治疗效果

Intervention of arterial elasticity and endothelial function in patients with hyperlipidemia

目的研究高脂血症患者内皮功能异常、早期动脉弹性改变及阿托伐他汀对这些改变的影响。方法选择未曾治疗的高脂血症患者40例作为研究组，健康体检者30例为对照组，应用在血管回声跟踪技术（eTRACKING）基础上实现的血流介导血管舒张检测技术（FMD）评估右肱动脉硬化参数及血管舒张参数，包括压力应变弹性系数（Ep）、硬度指数（p）、顺应性（AC）及收缩期血流介导血管舒张（FMDs）、舒张期血流介导血管舒张（FMDd）；研究组给予阿托伐他汀20mg口服，12周后复查总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）及上述参数，并进行统计学分析。结果研究组B、Ep均较对照组明显升高（均P〈0．001），而AC、FMDs、FMDd较对照组明显降低（均P〈0．001）；研究组治疗前后比较：TC、LDL·C、β、Ep降低，AC、FMDs、FMDd升高并有统计学意义（均P〈0．001）。结论高脂血症患者在动脉内膜出现异常改变之前已出现内皮功能损伤及血管早期硬化改变，而阿托伐他汀干预能逆转这些改变。

Objective To research the endothelial dysfunction and early changes in arterial elasticity in patients with hyperlipidemia and effects of atorvastatin on these changes. Methods 40 patients with hyperlipidemia but without any treatment in our hospital were selected as a study group, and 30 healthy people were selected as control group. Use the Flow mediated dilation, FMD detection which bases on the echo-trackingteehnology, eTRACKING to evaluate the fight brachial atherosclerosis parameters and vascular diastolic parameters,including the pressure strain elastic modulus（Ep） ;stiffness index（13） ;compliance（AC） ;FMDs and FMDd. The study group take atorvastatin 20rag per day,then retested above parameters and TC, LDL-C after 12 weeks and analyzed all parameters. Results The values of β and Ep in study group are significantly higher than the control group（ all P 〈 0. 001 ）, but AC;FMDs and FMDd are significantly lower than the control group（ all P 〈 0. 001 ）. The results of the study group after the treatment of atorvastatin are as follwing ： TC, LDL-C, β and Ep are lower than before, AC, FMDs and FMDd are higher than before ; and the differences are of significance in statistics （ all P 〈 0. 001 ）. Conclusion Hyperlipidemic patients had shown the vascular endothelial injury and vascular early hardening before the abnormal changes in intimal, but the atorvastatin intervention could reverse these changes.