辛伐他汀对冠心病患者血管内皮细胞功能障碍的治疗作用(英文)

Therapeutic effects of simvastatin on vascular endothelial cell dysfunction in patients with coronary heart disease

目的:研究辛伐他汀对冠心病患者血管内皮细胞功能障碍的干预作用。方法:90例冠心病患者按LDL-C水平分为三组:辛伐他汀20mg组(37例,LDL-C≥2.5mmol/L),辛伐他汀10mg组(35例,2.5mmol/L>LDL-C≥1.8mmol/L),常规治疗组(18例,LDL-C<1.8mmol/L,未服辛伐他汀),疗程均为8周。应用彩色多普勒超声诊断仪测量受试者肱动脉血流介导的舒张功能(FMD)。应用硝酸还原酶法检测受试者一氧化氮(NO)的含量。常规检测血清TC、TG、LDL-C及HDL-C的浓度。结果:8周后,与治疗前比较,辛伐他汀20mg,10mg组TC、TG和LDL-C浓度明显下降(P均<0.05),而HDL-C明显升高(P均<0.05);辛伐他汀20mg组与10mg组间各指标差异无显著性(P>0.05);与常规治疗组比较,辛伐他汀20mg、10 mg组FMD[(6.01±0.49)%比(9.01±0.39)%比(9.01±0.47)%]明显改善(P均<0.01)、血清NO含量[(38.97±8.89)μmol/L比(47.67±10.89)μmol/L比(45.61±9.09)μmol/L]明显升高(P均<0.05),辛伐他汀20mg、10 mg组两组间NO和FMD亦无显著差异(P>0.05)。结论:辛伐他汀可增加冠心病患者一氧化氮含量,改善血管内皮细胞功能,其作用机制与降低血清总胆固醇、甘油三酯和低密度脂蛋白可能有一定关系,但该作用无明显的量效关系,可能独立于降脂作用之外。

Objective：To study therapeutic effects of simvastatin on vascular endothelial cell dysfunction in patients with coronary heart disease（CHD）.Methods：According to LDL-C level,a total of 90 CHD patients were divided into simvastatin 20mg group（n=37,LDL-C≥2.5mmol/L）,simvastatin10mg group（n=35,1.8mmol/L≤LDL-C ＆lt;2.5mmol/L）and routine treatment group（n=18,LDL-C＆lt;1.8mmol/L）.Their course of treatment was 8 weeks.Color Doppler ultrasound diagnostic instrument was used to measure flow-mediated dilation of brachial artery（FMD）,and nitrate reductase method was used to measure concentration of nitric oxide（NO）in all CHD patients.Serum concentrations of TC,TG,LDL-C and HDL-C were routinely measured.Results：After treatment of eight weeks,compared with before treatment,there were significant decrease in concentrations of TC,TG and LDL-C（P＆lt;0.05 all）,and significant increase in HDL-C level（P＆lt;0.05 all）in simvastatin 20mg and 10mg group,but there were no significant difference in above-mentioned all indexes between simvastatin20mg and10mg groups,P＆gt; 0.05 all;Compared with routine treatment group,there were significant improvement in FMD[（6.01±0.49）%vs.（9.01±0.39）% vs.（9.01±0.47）%,P＆lt;0.01 all]and significant increase in serum NO concentration[（38.97± 8.89）μmol/L vs.（47.67±10.89）μmol/L vs.（45.61±9.09）μmol/L,P＆lt;0.05 all]in simvastatin 20mg and 10mg group;But there were also no significant difference in serum NO and FMD between simvastatin 20mg and 10mg groups,P＆gt;0.05 all.Conclusion：Simvastatin can increase NO concentration and improve vascular endothelial cell dysfunction in CHD patients.Its mechanism may be related with lipid-lowering effect,but independent of its lipid-lowering effect.