《中国康复理论与实践》 ›› 2006, Vol. 12 ›› Issue (11): 992-994.

• 临床研究 • 上一篇    下一篇

急性冠脉综合征患者早期应用辛伐他汀对血管内皮功能的保护作用

陈思远1; 贾三庆2; 赵敏2; 张谦2   

  1. 1.北京博爱医院内科,北京市 100068;2.首都医科大学附属友谊医院心血管中心,北京市 100050
  • 收稿日期:2006-08-11 出版日期:2006-11-01 发布日期:2006-11-01

Simvastatin Improve Endothelial Function Early after Acute Coronary Syndromes

CHEN Si-yuan, JIA San-qing, ZHAO Min, et al   

  1. Department of Internal Medicine, Beijing Charity Hospital, Beijing 100068, China
  • Received:2006-08-11 Published:2006-11-01 Online:2006-11-01

摘要: 目的观察他汀类降脂药物对急性冠脉综合症患者血管内皮功能的短期效果。方法60例急性冠脉综合征(急性心肌梗死、非ST段抬高心肌梗死/不稳定心绞痛)患者被随机分为2组,对照组30例,辛伐他汀组30例(辛伐他汀20 mg/d)。服药前和服药3~5 d后分别重复测定右侧肱动脉的血管内皮依赖性舒张百分数(FMD)。结果FMD治疗前两组间无显著性差异,对照组FMD在治疗后无明显变化(P=0.525),而辛伐他汀组的FMD在治疗后由(2.65±2.95)%上升至(4.19±2.59)%(P=0.027)。FMD的改善与总胆固醇(TC)(R2=0.081,P=0.37)、低密度脂蛋白胆固醇(LDL-C)(R2=0.056,P=0.46)、高密度脂蛋白胆固醇(HDL-C)(R2=0.073,P=0.40)的变化没有相关性。硝酸甘油诱导的血管扩张在两组患者在治疗前后均无显著性改变。结论急性冠脉综合征的患者在口服辛伐他汀后短期即可以改善血管内皮功能;此药理作用与血脂下降程度无相关性。

关键词: 急性冠脉综合征, 胆固醇, 辛伐他汀, 内皮

Abstract: ObjectiveTo explore the value of simvastatin in improving endothelial function in the patients with acute coronary syndromes in shorter time.Methods60 patients with acute coronary syndrome(acute myocardial infarction and unstable angina/non-ST elevation myocardial infarction) were randomized to be treated with placebo(n=30) or simvastatin 20 mg daily(n=30) for 3~5 d.At the admission and endpoint,Brachial ultrasound was used to measure endothelium-dependent flow-mediated dilatation(FMD) and response to endothelium-independent nitroglycerin. ResultsFMD was unchanged with placebo,but increased with simvasatin,from(2.65±2.95)% to(4.19±2.59)%(P=0.027).Responses to nitroglycerin were similar during the time course of the study in the 2 groups.The improvement of FMD was not correlated with the level of TC(R2=0.081,P=0.37),LDL-C(R2=0.056,P=0.46) or HDL-C(R2=0.073,P=0.40).ConclusionSimvastatin initiated early after acute coronary syndromes rapidly improves endothelial function in short course.No correlation has been detected between the pharmacological effects of simvastatin with the fall in TC and LDL-C.

Key words: acute coronary syndrome, cholesterol, simvastatin, endothelium

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