辛伐他汀对阿司匹林低反应者内皮功能及血小板聚集率的影响

Influence of simvastatin on the endothelial function and platelet aggregation rate in the patients with aspirin low biochemical response

目的探讨辛伐他汀对高血压病合并高脂血症及阿司匹林低生化反应患者内皮功能及血小板聚集率的影响。方法采用前瞻性随机对照研究,口服肠溶阿司匹林片1周后,高血压病合并高脂血症及阿司匹林低生化反应患者109例入选,检测用花生四烯酸(AA)和二磷酸腺苷(ADP)作诱导剂的血小板聚集率(PAG)和一氧化氮、内皮素指标;然后采用信封法随机分为辛伐他汀组和对照组,均继续口服阿司匹林,辛伐他汀组加用辛伐他汀。治疗2月后复查上述指标,观察辛伐他汀对上述指标的影响。结果对照组两次检测内皮素、一氧化氮浓度及以AA和ADP诱导的PAG,差异均无统计学意义(t分别=1.66、0.56、1.13、0.13,P均>0.05)。治疗2月后,辛伐他汀组内皮素及以AA和ADP诱导的PAG检测值明显降低,一氧化氮浓度增高,差异均有统计学意义(t分别=14.51、6.09、5.64、15.07,P均<0.05);同时与对照组治疗后比较,辛伐他汀组内皮素及以AA和ADP诱导的PAG明显降低,一氧化氮浓度明显升高,差异均有统计学意义(t分别=17.48、3.39、2.05、11.41,P均<0.05)。结论辛伐他汀可改善高血压病合并高脂血症及阿司匹林低生化反应患者血管内皮功能,可能同时改善阿司匹林抗血小板聚集功能。

Objective To investigate the impact of simvastatin on the endothelial function and platelet aggregation rate in patients with low aspirin biochemical responsiveness. Methods After taking aspirin for one week, 109 cases of hyper-tensive patients combined with hyperlipidemia and low aspirin biochemical responsiveness were assigned. The blood levels of platelet aggregation rate （PAG） that induced by arachidonic acid （AA） and adenosine diphosphate （ADP）, nitric oxide （NO） and endothelin （ET） were detected. Then they were randomly divided into control group and the simvastatin group. Both group continued to take aspirin while the simvastatin group were given simvastatin. After two months, these indicators were detected again. Results No change of PAG, ET and NO was observed in the control group（t=1.66,0.56,1.13,0.13, P〉0.05）. In the simvastatin group, concentration of ET, PAG induced by AA and ADP were significantly reduced while concentration of NO was significantly increased （t=14.51, 6.09,5.64,15.07,P〈0.05）. Compared with the control group, the PAG induced by ADP, ET and AA of the simvastatin group were significantly reduce while the concentration of NO was significantly increased（t=17.48,3.39,2.05,11.41,P〈0.05）. Conclusion Simvastatin may not only improve endothelial function in hypertensive patients combined with hyperlipidemia and low aspirin biochemical responsiveness, but also im-prove the function of aspirin anti-platelet aggregation at the same time.