阿托伐他汀对冠心病患者内皮舒张功能影响的研究

The Effect of Atorvastatin on Endothelial Dilated Function in Patients with Coronary Heart Disease

目的 超声检测内皮依赖性及非依赖性舒张功能 ,研究冠心病 (CHD)患者内皮功能的变化及其临床意义。研究 3羟基 -3甲基戊二酰辅酶A(HMG -CoA)还原酶抑制剂———阿托伐他汀在改善内皮功能方面的作用。方法 12 0例患者应用高频超声检测肱动脉血流介导的及硝酸甘油 (GTN)引起的舒张反应 ,并观察阿托伐他汀治疗 10～ 12周后内皮舒张功能的变化。结果 总胆固醇 (TC)、低密度脂蛋白胆固醇 (LDL -C)水平及高血压、糖尿病发病率在冠心病组中明显高于对照组。冠心病组的肱动脉基础内径略大于对照组 ,但无统计学意义 (P >0 0 5 )。冠心病组由血流介导的以及GTN引起的肱动脉舒张反应 ,均明显低于对照组 (P<0 0 1)。经阿托伐他汀治疗后 ,冠心病患者的内皮舒张功能有明显改善 ( P <0 0 1)。结论 在冠心病患者和有危险因素的人群中开展血管内皮功能检查 ,可为早期发现、预防和治疗冠心病提供依据 ,可作为监测和评估病情变化的指标。阿托伐他汀具有改善内皮功能的作用。

Objective To investigate the effect of atorvastatin on endothelial dilated function in the patients with coronary heart disease (CHD). Methods The dilatation of brachial arteries during reactive hyperemia and after sublingual administraction of glyceryl trinitrate (GTN) were measured by using B-mode ultrasonography in 120 patients. The endothelial dilatation changes 10～12 weeks after treatment of atorvastatin were observed. Results The content of TC, LDL-C and the incidences of hypertension and diabetes mellitus were higher in CHD group than those in the control group. The flow-mediated dilatation and GTN-induced dilatation of brachial arteries in patients with CHD were significantly reduced as composed with those in control group(P<0 01). After treatment of atorvastatin, the endothelial function of patients with CHD was improved significantly(P<0 05). Conclusions In the patients with CHD and persons with CHD risk factors, Using B-mode ultrasonography to measure the endothelial function can provide evidences for early diagnosis, prevention and treatment of CHD. The results also suggest that atorvastatin has the role of improving the endothelial function.