阿托伐他汀钙对急性心肌梗死患者血管内皮细胞功能的影响

The effect of atorvastatin on the endothelial function in patients with acute myocardial infarction

目的 观察心肌梗死急性期降脂治疗对内皮依赖性血管舒张功能的作用。方法 采用超声法检测 2 0例急性心肌梗死 (AMI)和 2 0例健康成年人肱动脉内皮依赖性舒张功能、内皮非依赖性舒张功能。 2 0例AMI患者在常规治疗 (血管紧张素转换酶抑制剂、β受体阻滞剂和阿司匹林等 )的基础上口服阿托伐他汀钙 10mg d ,8周后复测肱动脉内皮依赖性舒张功能、内皮非依赖性舒张功能和血脂全套。结果 AMI患者肱动脉内皮依赖性舒张功能 (2 .5 3± 1.18) %较对照组 (8.6 9± 3.31) %明显降低 (P<0 .0 0 1) ,AMI组的肱动脉内皮非依赖性舒张功能 (17.2 1± 5 .36 ) %也较对照组 (2 5 .18± 9.34) %明显降低 (P <0 .0 1)。AMI患者服用 10mg d阿托伐他汀钙治疗 8周后 ,肱动脉内皮依赖性舒张功能 (6 .32±2 .86 ) %较治疗前 (2 .5 3± 1.18) %有显著改善 (P <0 .0 1)。肱动脉内皮非依赖性舒张功能与治疗前比较差异无显著性 (17.0 4 %± 5 .2 7%vs 17.2 1%± 5 .36 % ,P >0 .0 5 )。治疗后TC、LDL C和TG水平明显降低 (P <0 .0 5 )。结论 AMI患者肱动脉内皮依赖性血管舒张功能明显减退 ,短期口服阿托伐他汀钙 (10mg d)

Objective To study the effect of atorvastatin on the endothelial function in patients with acute myocardial infarction(AMI).Methods The endothelial dependent vasodilatation(flow mediated vasodilatation)of brachial artery and non endothelial dependent vasodilatation were measured by ultrasound technique in 20 paitents with AMI and in 20 age matched normal subjects.The patients with AMI recived conventional medication plus atorvastatin 10 mg/d for 8 weeks.The studies of vasodilatation of brachial artery for each patient were performed before,8 weeks after treatment.Results In patients with AMI,endothelial dependent vasodilatation(2.53±1.18)% was significantly reduced compared with that in the age matched normal subjects(8.69±3.31)%,P<0.001,but it was significantly improved after 10 mg/d atorvastatin plus conventional therapy(6.32±2.86)%,P<0.01.Conclusion This study indicated that endothelial dependent vasodilatation is impaired in patients with AMI,which can be improved by 10 mg/d atorvastatin therapy in short period.