调脂治疗对老年心绞痛冠脉血流储备的影响

Effects of Cholesterol-lowering Therapy with Pravastatin on Coronary Flow Reserve in Elderly Patients with Angina Pectoris

目的 :研究普伐他汀治疗对临床有心绞痛症状而冠状动脉造影轻度狭窄伴高胆固醇血症老年患者冠脉血流储备 (CFR)的影响。方法 :用彩色多普勒超声仪检测 18例冠心病心绞痛冠状动脉造影轻度狭窄伴高胆固醇血症老年患者 ,采用普伐他汀调脂治疗 6个月后进行治疗前后CFR比较 ,并与 2 0例健康老年血浆胆固醇正常者 (对照组 )比较。结果 :18例患者经过 6个月治疗后 ,血浆总胆固醇 (TC)由 6 84± 0 85mmol/L降至 5 2 9± 0 82mmol/L(P <0 .0 0 1) ,低密度脂蛋白胆固醇 (LDL C)由 4 2 2± 0 73mmol/L降至 3 4 3± 0 82mmol/L(P <0 .0 0 1) ,CFR由治疗前 3 33± 0 71mmol/L升至 3 86± 0 83mmol/L(P <0 .0 1)。TC及LDL C与CFR呈负相关关系 (r =- 0 4 3及- 0 4 6 ,P <0 .0 5 )。结论 :普伐他汀调脂治疗可以改善心绞痛冠状动脉轻度狭窄患者的冠状动脉微循环 ,提高CFR。

Objective:To investigate the effects of cholesterol lowering therapy with pravastatin on coronary flow reserve in elderly patients with angina pectoris and hypercholesterolemia. Methods:By using color Doppler ultrasound, the coronary flow reserve was measured in 18 elderly patients with angina pectoris before and after 6 month cholesterol lowering therapy and in 20 normal elderly subjects. Results: After cholesterol lowering therapy for 6 months, the serum total cholesterol (TC) was lowered from 6.48±0.85 mmol/L to 5.29±0.82 mmol/L ( P < 0.001 ), low density lipoprotein cholesterol (LDL C) from 4.22±0.73 mmol/L to 3.43±0.82 mmol/L ( P < 0.001 ) and the coronary flow reserve was increased from 3.33±0.71 to 3.86±0.83 ( P <0.01). An inverse correlation was found not only between TC and CFR ( r =-0.43, P =0.008), but also between LDL C and CFR ( r = -0.46 , P =0.005). Conclusion:Cholesterol lowering therapy with pravastatin may improve coronary flow reserve in elderly patients with angina pectoris and hypercholesterolemia.