普伐他汀对冠状动脉硬化斑块及心血管事件的影响

Effects of pravastatin on atherosclerotic plaque and cardiovascular events in patients with coronary disease

目的 :观察普伐他汀 (10 m g/ d)对动脉硬化斑块和心血管事件的影响。 方法 :5 7例冠心病患者 (4 4例男性、13例女性 ) ,年龄 (5 8.4± 11.3)岁 ,随机分成两组 ,治疗组在冠脉造影当晚起口服普伐他汀 10 mg/ d,经平均 7.3个月随访 ,复查冠脉造影和血脂。 结果 :(1)普伐他汀具有明显调脂作用 ,总胆固醇 (TC)、低密度脂蛋白胆固醇 (L DL - C)和甘油三酯 (TG)分别下降 15 .0 % (P<0 .0 1)、18.0 % (P<0 .0 1)和 6 .0 % ,高密度脂蛋白胆固醇 (HDL - C)升高 10 .6 % ;对照组 TC和 L DL - C有下降趋势 ,但无统计学意义。(2 )两组治疗前后血管直径无明显变化。(3)治疗组急性心肌梗死、需行 PTCA或 CABG的反复心绞痛等心血管事件发生率明显减少 (P<0 .0 5 )。 (4 )普伐他汀对心率、血压和左室射血分数无明显影响。结论 :普伐他汀能稳定斑块、减少心血管事件的发生率 ,这一作用可能与其调脂作用有关。

Objective: To investigate the effects of pravastatin on atherosclerotic plaque and cardiovascular events. Methods: Fifty seven patients with coronary artery disease (44 male and 13 female, 58.4±11.3 years) were randommized into pravastatin and control groups. The patients in pravastatin group were administered 10 mg of pravastatin from the night of coronary angiography day. After 7.3 months (mean) of follow up, plasma lipid parameters and coronary angiograph were repeated. Results: (1) A favorable effect on plasma lipid parameters was found. After administration, total cholesterol(TC), low density lipoprotein cholesterol (LDL C) and triglyceride(TG) reduced by 15.0% ( P <0.01), 18.0% ( P <0.01) and 6 0%, respectively. High density lipoprotein cholesterol(HDL C) increased by 10.6%. However, in control group, TC and LDL C showed a tendency to reduce, but no significant difference was found between those of pre and post administration. (2)There was no significant difference in luminal diameter between pre and post administration in both groups. (3) Cardiovascular events in pravastatin group was significantly lower than those in control ( P <0.05). (4) Pravastatin had no significant effect on HR, BP and left ventricular ejection fraction in both groups. Conclusion: Pravastatin can stabilize coronary atherosclerostic plaque and reduce the incidence of cardiovascular events by improving plasma lipid parameters. [