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辛伐他汀降脂治疗对血管内皮依赖性舒张功能的影响

Cholesterollowing therapy with simvastatin improves brachial endotheliumdependent relaxation

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【作者】 李江赵水平李向平周启昌高梅

【Author】 Li jiang , Zhao Shuiping , Li Xiangping , et al. Department of Cardiology, Second Affiliated Hospital , Hunan Medical University, Changsha 410011

【机构】 湖南医科大学附属第二医院心内科

【摘要】 目的研究辛伐他汀对原发性高胆固醇血症患者血管内皮依赖性舒张功能的影响。方法采用高分辨超声技术,对25例原发性高胆固醇血症患者降脂前后和25例血浆胆固醇水平正常的对照者的血管内皮依赖性舒张功能进行检测。结果发现原发性高胆固醇血症组肱动脉血流介导性舒张较正常组明显减弱(3.5%±2.8%和14.5%±3.4%,P<0.001),而二组对硝酸甘油的反应无显著性差异(20.5%±7.2%比22.9%±4.3%,P=0.49)。25例原发性高胆固醇血症患者服用辛伐他汀5~10mg治疗3.8±0.8月后,血浆总胆固醇从6.31±0.70mmol/L降至5.06±0.63mmol/L,同时肱动脉内皮依赖性舒张较治疗前明显改善(10.0±3.2%比3.5±2.8%,P<0.001),而治疗前后肱动脉对硝酸甘油的反应无显著性改变。结论原发性高胆固醇血症患者存在血管内皮依赖性舒张功能障碍;经辛伐他汀降胆固醇治疗后,受损的血管内皮依赖性舒张功能得到明显改善

【Abstract】 Objective To investigate the effect of cholesterollowering therapy with simvastatin on endotheliumdependent relaxing function in patients with hypercholesterolemia. Methods With highresolution ultrasound, we measured endotheliumdependent relaxing function in 50 subjects: 25 of them with normal blood cholesterol and the others with established primary hypercholesterolemia.Results In patients with primary hypercholesterolemia, flowmediated dilatation in arteries was much reduced comparied with control group (3.5%±2.8% vs 14.5%±3.4%, P<0.001). However, there was no significant difference in response to nitroglycerin between the two groups (20.5%±7.2% vs 22.9%±4.3%, P=0.49). Twentyfive hypercholesterolemic patients were studied before and after cholesterollowering therapy with simvastatin (an inhibitor of HMGCoA reductase) for 3.8±0.8 months, by which serum cholesterol lowered from 6.31±0.70 mmol/L to 5.06±0. 63 mmol/L (P<0.001). Flowmediated vasodilations were greater after simvastatin therapy than before (10.0±3.2% vs 3.5±2. 8%,P<0.001). The vasodilation response to nitroglycerin was no significant change after cholesterollowering therapy. Conclusion Endotheliumdependent vasodilation was impaired in patients with primary hypercholesterolemia, and cholesterollowering therapy with simvastatin may improve impaired endotheliumdependent vasodilation.

【关键词】 辛伐他汀; 高胆固醇血症; 内皮.血管; 血管舒张; 超声检查.多普勒; 彩色;

【Key words】 simvastatin hypercholesterolemia endothelium; vascular vasodilation ultrasongraphy; Doppler; color;

【分类号】R331.32;R972.6;R589.22;

【基金】 卫生部国际交流默沙东基金

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