瑞舒伐他汀对家族性高胆固醇血症患者血脂水平和颈动脉内膜中层厚度及血管内皮舒张功能的影响

Effect of rosuvastatin on blood lipid,carotid intima-media thickness and vascular endothelial diastolic function in patients with familial hypercholesterolemia

目的探讨瑞舒伐他汀对家族性高胆固醇血症(FH)患者血脂水平和颈动脉内膜中层厚度(IMT)及血管内皮舒张功能的影响。方法选取2014年12月至2017年8月内蒙古医科大学附属医院神经内科门诊就诊的FH患者93例(FH组),在饮食指导基础上给予瑞舒伐他汀钙片治疗,选择同期门诊体检健康的志愿者60名为健康对照组,比较2组研究对象基线血脂水平、IMT和血管内皮舒张功能指标,以及FH组患者治疗3个月后血脂、IMT和血管内皮舒张功能指标的改善情况。结果 FH组基线血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇水平均高于健康对照组,高密度脂蛋白胆固醇水平低于健康对照组(均P<0.05)。FH组治疗3个月后血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇水平[(4.1±0.4)、(1.33±0.31)、(2.67±0.43)mmol/L]均低于基线水平,高密度脂蛋白胆固醇水平[(1.2±0.4)mmol/L]高于基线水平(均P <0.05)。FH组基线血管内皮依赖性舒张功能及血管内皮非依赖性舒张功能水平均低于健康对照组[(5.7±2.4)%比(10.3±3.4)%,(17±5)%比(19±8)%],IMT高于健康对照组[1.35 (0. 35,1. 73) mm比0.71 (0.43,1. 05)mm](均P <0. 05)。FH组治疗3个月后IMT[0. 82(0. 21,1. 12) mm]低于基线水平,血管内皮依赖性舒张功能及血管内皮非依赖性舒张功能水平[(9. 3±3. 3)%、(18±5)%]均高于基线水平(均P<0.05)。结论瑞舒伐他汀可显著降低FH患者血脂水平和IMT,改善血管内皮舒张功能。

Objective To explore the effect of rosuvastatin on blood lipid, carotid intima-media thickness(IMT) and vascular endothelial diastolic function in patients with familial hypercholesterolemia(FH). Methods From February 2014 to August 2017, 93 patients with FH were enrolled in the Affiliated Hospital of Inner Mongolia Medical University;60 healthy people were enrolled as control group. FH patients were treated with rosuvastatin calcium tablets. Blood lipid, IMT and vascular endothelial diastolic function indexes were analyzed. Results Before treatment, levels of serum total cholesterol, triglyceride and low-density lipoprotein cholesterol in FH group were higher than those in control group;high-density lipoprotein cholesterol level in FH group was lower than that in control group(all P<0.05). After 3 months of treatment, serum total cholesterol, triglyceride and low-density lipoprotein cholesterol in FH group[(4.1±0.4),(1.33±0.31),(2.67±0.43)mmol/L] were lower and high-density lipoprotein cholesterol[(1.2±0.4)mmol/L] was higher than the baseline levels(all P<0.05). Before treatment, vascular endothelium dependent diastolic function and non-dependent diastolic function in FH group were lower than those in control group[(5.7±2.4)% vs (10.3±3.4)%, (17±5)% vs (19±8)%];IMT in FH group was higher than that in control group[1.35(0.35,1.73)mm vs 0.71(0.43,1.05)mm](all P<0.05). After treatment, IMT significantly decreased[0.82(0.21,1.12)mm] and vascular endothelium dependent diastolic function and non-dependent diastolic function significantly increased[(9.3±3.3)%, (18±5)%] in FH group(all P<0.05). Conclusion Rosuvastatin can significantly reduce blood lipid level and IMT, improve vascular endothelial diastolic function in FH patients.