阿托伐他汀钙对原发性高胆固醇血症患者血管内皮细胞依赖性舒张功能的影响

Tne effect of cholesterol-lowering therapy with atorvastatin on endothelium-dependent relaxing function in patients with hypercholesterolemia

目的 :研究阿托伐他汀钙对原发性高胆固醇血症 (HTC)患者血管内皮细胞依赖性舒张功能 (FMD)的影响。方法 :采用高分辨率超声技术 ,对 30例 HTC患者用阿托伐他汀钙治疗前后和 30例血浆胆固醇 (TC)水平正常的对照 (NC)组的血管 FMD进行检测。结果 :HTC组肱动脉 FMD较 NC组明显减弱 (3.4 %± 2 .6 % vs 13.8%± 3.8% ,P<0 .0 1) ,而两组对硝酸甘油反应的内皮非依赖性舒张功能 (NMD)无显著性差异 (P>0 .0 5 )。 30例 HTC患者服用阿托伐他汀钙 10 mg治疗 12周后 ,TC从 6 .3± 0 .6 mm ol/ L降至 5 .0± 0 .5 mm ol/ L ,甘油三酯 (TG)从 1.8± 0 .4mm ol/ L降至 1.5± 0 .6 mmol/ L ,L DL - C从 4 .2± 0 .5 m mol/ L降至 3.0± 0 .6 mm ol/ L ,同时 FMD较治疗前显著改善 (11.6 %± 3.3% vs 3.4 %± 2 .6 % ,P<0 .0 1) ,而治疗前后肱动脉 NMD无显著性改变 (P>0 .0 5 )。结论 :HTC患者存在 FMD障碍 ,经阿托伐他汀钙降胆固醇治疗后 ,受损的血管

AIM:To investigate the effect of cholesterol lowering therapy with atorvastatin on endothelium dependent relaxing function in patients with hypercholesterolemia(HTC). METHODS:With high resolution ultrasound,we measured endothelium dependent relaxing function in 60 subjects:30 with normal blood cholesterol and the others with established primary HTC. RESULTS:In patients with primary HTC,flow mediated dilatation in arteries was markedly reduced comparied with the control group(3.4%±2.6% vs 13.8%±3.8%, P <0.01),However,there was no significant difference in the response to nitroglycerin between the two groups( P >0.05). The 30 HTC patients were studied before and after cholesterol lowering therapy with atorvastatin for 12 weeks,during which serum TC lowered from 6.3±0.6 mmol/L to 5.0±0.5 mmol/L(P<0.01),TG lowered from 1.8±0.4 mmol/L to 1.5±0.6 mmol/L( P <0.05), and LDL C?lowered from 4.2±0.5 mmol/L to 3.0±0.6 mmol/L( P <0.01). Flow mediated vasodilations were greater after the atorvastatin therapy than before it (11.6±3.3% vs 3.4±2.6%, P <0.01). There was no significant change in vasodilations response to nitroglycerin after the cholesterol lowering therapy( P >0.05). CONCLUSION:Endothelium dependent vasoldilation was impaired in patients with primary HTC,and cholesterol lowering therapy with atorvastatin may the improve impaired endothelium dependent vasodilation.