阿托伐他汀对高血脂合并稳定型心绞痛及无症状性冠心病患者血清脂联素及血管内皮功能的影响

Effect of Atorvastatin on Serum Adiponectin and Blood Vessel Endothelium Function in Patients with Hyperlipemia Combined with Stable Angina Pectoris and Asymptomatic Coronary Artery Disease

目的观察阿托伐他汀对高血脂合并稳定型心绞痛及无症状性冠心病患者血清脂联素及血管内皮功能的影响。方法将150例高血脂合并稳定型心绞痛及无症状性冠心病患者按随机数字表法分为3组:对照组、观察Ⅰ组和观察Ⅱ组。对照组给予银丹心脑通软胶囊及冠心病常规治疗;观察Ⅰ组另给予阿托伐他汀20 mg/d;观察Ⅱ组另给予阿托伐他汀40 mg/d;疗程12周。治疗前后采集空腹静脉血,检测血清脂联素、淀粉样蛋白A及血管内皮功能指标:一氧化氮和内皮素1变化。结果治疗后观察Ⅰ组、观察Ⅱ组血清脂联素和一氧化氮均较治疗前明显升高(P<0.05);内皮素1和淀粉样蛋白A则明显降低(P<0.05);治疗后观察Ⅱ组与观察Ⅰ组比较各指标的变化幅度更大(P<0.05)。血清脂联素与一氧化氮呈显著正相关,与内皮素1及淀粉样蛋白A呈显著负相关。结论阿托伐他汀可能通过降低血清脂联素水平而改善血管内皮功能,发挥抗动脉粥样硬化作用。

Aim To observe the effect of atorvastatin on serum adiponectin and blood vessel endothelium function in patients with hyperlipemia combined with stable angina pectoris and asymptomatic coronary artery disease. Method 150 cases with hyperlipemia combined with stable angina pectoris and asymptomatic coronary artery disease were randomly divided into three groups. Control group was given conventional treatment of coronary heart disease ; observation group I was treated with additional atorvastatin 20 mg/d; observation group 11 received additional atorvastatin 40 mg/d. The treatment duration was 12 weeks. Fasting venous blood was collected to detect serum levels of adiponectin, serum amyloid A, nitric oxide and endothelin-1. The changes of nitric oxide and endothelin-1 were used as indirect indexes for blood vessel endothelium function. Results After treatment, serum levels of adiponectin and nitric oxide were in- creased, but endothelin-1 and serum amyloid A were decreased in observation group Ⅰ and Ⅱ（ all P 〈 0.05 ）, with signifi- cantly greater changes of each index in observation group Ⅱ than those in group Ⅰ. Serum adiponectin correlated signifi- cantly with nitric oxide, and was inversely related to endothelin-1 and serum amyloid A. Conclusion Atorvastatin im- proves blood vessel endothelium function via reduction of serum adiponectin level. This agent may play an important role in the prevention of atherosclerosis.