冠心病患者应用他汀对动脉僵硬度的影响

Effect of Statins on arterial stiffness in patients with coronary artery disease

目的观察在冠心病(CAD)患者中应用他汀对动脉僵硬度的影响,评估他汀应用与动脉僵硬度的关系。方法 2011年11月-2012年12月,纳入在阜外心血管病医院住院的160例冠心病患者,其中77例服用他汀(他汀组),83例未服用他汀(非他汀组,为未接受正规治疗的冠心病患者),排除高血压、心衰等其他重要的心血管疾病患者。检测患者的臂踝脉搏波速度(ba-PWV),应用SPSS 13.0统计软件,采用t检验、χ2分析及多元线性回归模型进行统计分析。结果在冠心病患者中,与非他汀组相比,他汀组的总胆固醇和低密度脂蛋白胆固醇水平显著降低(P<0.01);他汀组的ba-PWV显著低于非他汀组(P=0.002)。进一步的多元线性回归分析表明,在调整混杂因素[如年龄、性别、体重指数(BMI)、收缩压(SBP)、高敏C反应蛋白(hs-CRP)及其他合并用药情况]后,他汀与ba-PWV的显著相关性仍具统计学意义(P=0.025)。结论在冠心病患者中,应用他汀和动脉僵硬度的改善具有显著的关联,并独立于其他重要的临床指标。这提示他汀可能会显著改善冠心病患者的动脉僵硬度,他汀对心血管疾病预后的改善可能与其改善动脉僵硬度的作用有关。

Objective To evaluate the relationship between the use of Statins and arterial stiffness in patients with coronary artery disease（CAD）,in order to help to clarify the effect of Statins on arterial stiffness in this population.Methods Brachial-ankle pulse wave velocity（ba-PWV） was measured in 160 CAD patients（77 used Statins,83 did not）.Multiple linear regression analyses were performed to evaluate the relationships between the use of Statins and ba-PWV.Results In CAD patients,total cholesterol and low density lipoprotein cholesterol（LDL-C） levels were sig nificantly lower in the statins group compared with that in the non-Statins group（P0.01）.The ba-PWV in the Statins group was significantly lower compared with that in the non-Statins group（P = 0.002）.The multiple linear regression analyses indicated that the Statins use remained to be correlated with the decrease of ba-PWV significantly（P = 0.025）,after adjusting for age,sex,body mass index（BMI）,systolic blood pressure（SBP）,diabetes,aspirin,smoking,angiotensin Ⅱ receptor blocker（ARB） or angiotensin-converting enzyme inhibitor（ACEI）,heart rate,fasting glucose,HbA1c,Lp（a） and hs-CRP（P=0.025）.Conclusion There is a significant relationship between the use of Statins and arterial stiffness independent of other important variables in CAD patients,suggesting that Statins may probably signifi cantly improve the arterial stiffness in CAD patients.