血脂康对冠心病合并高脂血症患者血管内皮细胞的保护作用

Protective effects of Xuezhikang on vasular endothelial cells in coronary heart disease with hypercholesteremia

目的 探讨血脂康调血脂治疗对冠心病合并高脂血症患者内皮细胞的保护作用。方法 70例血浆胆固醇水平大于 5 .72mmol L并经冠状动脉造影证实的冠心病患者作为研究对象 ,4 8例给予降血脂治疗 ,2 2例给予安慰剂 ,另 10例无明显危险因素 ,年龄、性别相匹配的冠状动脉正常者作为对照。患病组分别于治疗前、后 4周及 8周采用高分辨率血管超声法检查上肢动脉内皮依赖性舒张功能 (VEDR) ,超速离心法检查血液中脱落的内皮细胞及放射免疫法测定血浆血友病因子 (vWf)的水平。结果 与正常对照组相比 ,患病组VEDR明显受损 ,脱落的内皮细胞也明显增加 ,血浆vWf的水平显著升高 (P <0 .0 1) ,治疗组 4周VEDR即有改善的趋势 ,8周后明显改善 (P <0 .0 5 ) ,而上肢动脉对硝酸甘油的反应性治疗前后未发生改变 ;治疗 8周后脱落的内皮细胞也明显减少 (P <0 .0 5 ) ,vWf的水平显著下降 (P <0 .0 1)。安慰剂组未见任何变化。

Objective To determine the protective effects of Xuezhikang on endothelial cells in coronary heart disease (CHD) with hypercholesteremia.Methods Seventy hypercholesteremic patients with CHD evidenced by coronary angiography were selected. Forty eight patients were treated with Xuezhikang, a lipid lowering agent, and other 22 cases with placebo.Ten subjects with normal plasma levels of lipids and normal coronary angiogram served as controls.Before and after 4 and 8 weeks of treatment, brachial artery endothelium dependent relaxation (VEDR) was evaluated by high resolution ultrasound techniques in the patients. The circulating detached endothelial cells were calculated and plasma levels of vWf were measured.Results Compared with controls, VEDR was signifcantly impaired, the number of circulating detached endothelial cells was increased and plasma levels of vWf were elevated in the patients.After 8 weeks of treatment with Xuezhikang, the impaired VEDR was significantly improved, the number of circulating detached endothelial cells was decreased and the plasma levels of vWf were also decreased.In placebo group,no changes were found.Conclusion Xuezhikang could effectively protect endothelial cells in CHD patients with hypercholesteremia.