中国循证心血管医学杂志
中國循證心血管醫學雜誌
중국순증심혈관의학잡지
CHINESE JOURNAL OF EVIDENCE-BASES CARDIOVASCULAR MEDICINE
2014年
2期
162-165
,共4页
武云涛%张薇%田国祥%夏常泉%王晓兵%姚璐%李响%郝万峰%张晓冬%张峰%宋慧敏%孙艳明%高迎春
武雲濤%張薇%田國祥%夏常泉%王曉兵%姚璐%李響%郝萬峰%張曉鼕%張峰%宋慧敏%孫豔明%高迎春
무운도%장미%전국상%하상천%왕효병%요로%리향%학만봉%장효동%장봉%송혜민%손염명%고영춘
血管内皮功能%冠状动脉粥样硬化症%一氧化氮%辛伐他汀
血管內皮功能%冠狀動脈粥樣硬化癥%一氧化氮%辛伐他汀
혈관내피공능%관상동맥죽양경화증%일양화담%신벌타정
Vascular endothelial function%Coronary atherosclerosis%Nitric oxide%Simvastatin
目的:观察不同剂量辛伐他汀对冠状动脉粥样硬化症患者血管内皮细胞功能的影响。方法纳入133例冠状动脉粥样硬化症患者,依据低密度脂蛋白胆固醇(LDL-C)水平将入组患者分为4组:LDL-C≥4.16 mmol/L患者30例,给予辛伐他汀40 mg/d干预治疗(40 mg组);3.64 mmol/L≤LDL-C<4.16 mmol/L患者35例,给予辛伐他汀20 mg/d干预治疗(20 mg组);2.6 mmol/L≤LDL-C<3.64 mmol/L患者37例,给予辛伐他汀10 mg/d干预治疗(10 mg组),LDL-C<2.6 mmol/L患者31例,不给予辛伐他汀治疗(对照组)。应用彩色多普勒超声诊断仪测量受试者肱动脉血流介导的舒张功能(FMD)及硝酸甘油介导的舒张功能(NMD),应用硝酸酶还原法检测受试者血清一氧化氮的含量。常规检测血清总胆固醇、甘油三酯、低密度脂蛋白及高密度脂蛋白的水平。结果治疗前,辛伐他汀干预组(10 mg组、20 mg组、40 mg组)患者血清NO水平与对照组比较无统计学差异(P>0.05)。治疗8周后,辛伐他汀干预组(10 mg组、20 mg组、40 mg组)患者NO水平显著升高,与治疗前比较,有明显统计学差异(P<0.05);与对照组比较有统计学差异(P>0.05)。对照组患者治疗前后NO水平无明显变化(P>0.05)。治疗前,辛伐他汀干预组(10 mg组、20 mg组、40 mg组)患者肱动脉内径基础值、FMD及NMD水平与对照组比较均无统计学差异(P>0.05)。治疗8周后,辛伐他汀干预组(10 mg组、20 mg组、40 mg组)患者肱动脉内径基础值、NMD水平与治疗前比较,无统计学差异(P>0.05);FMD水平较治疗前显著增加,与对照组比较也呈明显增加趋势,差异有统计学意义(P<0.05);NMD水平与与照组比较,差异无统计学意义(P>0.05)。结论辛伐他汀可增加冠状动脉粥样硬化症患者血清一氧化氮水平,改善血管内皮细胞功能,其作用机制与改善血脂水平无明显的量效关系。
目的:觀察不同劑量辛伐他汀對冠狀動脈粥樣硬化癥患者血管內皮細胞功能的影響。方法納入133例冠狀動脈粥樣硬化癥患者,依據低密度脂蛋白膽固醇(LDL-C)水平將入組患者分為4組:LDL-C≥4.16 mmol/L患者30例,給予辛伐他汀40 mg/d榦預治療(40 mg組);3.64 mmol/L≤LDL-C<4.16 mmol/L患者35例,給予辛伐他汀20 mg/d榦預治療(20 mg組);2.6 mmol/L≤LDL-C<3.64 mmol/L患者37例,給予辛伐他汀10 mg/d榦預治療(10 mg組),LDL-C<2.6 mmol/L患者31例,不給予辛伐他汀治療(對照組)。應用綵色多普勒超聲診斷儀測量受試者肱動脈血流介導的舒張功能(FMD)及硝痠甘油介導的舒張功能(NMD),應用硝痠酶還原法檢測受試者血清一氧化氮的含量。常規檢測血清總膽固醇、甘油三酯、低密度脂蛋白及高密度脂蛋白的水平。結果治療前,辛伐他汀榦預組(10 mg組、20 mg組、40 mg組)患者血清NO水平與對照組比較無統計學差異(P>0.05)。治療8週後,辛伐他汀榦預組(10 mg組、20 mg組、40 mg組)患者NO水平顯著升高,與治療前比較,有明顯統計學差異(P<0.05);與對照組比較有統計學差異(P>0.05)。對照組患者治療前後NO水平無明顯變化(P>0.05)。治療前,辛伐他汀榦預組(10 mg組、20 mg組、40 mg組)患者肱動脈內徑基礎值、FMD及NMD水平與對照組比較均無統計學差異(P>0.05)。治療8週後,辛伐他汀榦預組(10 mg組、20 mg組、40 mg組)患者肱動脈內徑基礎值、NMD水平與治療前比較,無統計學差異(P>0.05);FMD水平較治療前顯著增加,與對照組比較也呈明顯增加趨勢,差異有統計學意義(P<0.05);NMD水平與與照組比較,差異無統計學意義(P>0.05)。結論辛伐他汀可增加冠狀動脈粥樣硬化癥患者血清一氧化氮水平,改善血管內皮細胞功能,其作用機製與改善血脂水平無明顯的量效關繫。
목적:관찰불동제량신벌타정대관상동맥죽양경화증환자혈관내피세포공능적영향。방법납입133례관상동맥죽양경화증환자,의거저밀도지단백담고순(LDL-C)수평장입조환자분위4조:LDL-C≥4.16 mmol/L환자30례,급여신벌타정40 mg/d간예치료(40 mg조);3.64 mmol/L≤LDL-C<4.16 mmol/L환자35례,급여신벌타정20 mg/d간예치료(20 mg조);2.6 mmol/L≤LDL-C<3.64 mmol/L환자37례,급여신벌타정10 mg/d간예치료(10 mg조),LDL-C<2.6 mmol/L환자31례,불급여신벌타정치료(대조조)。응용채색다보륵초성진단의측량수시자굉동맥혈류개도적서장공능(FMD)급초산감유개도적서장공능(NMD),응용초산매환원법검측수시자혈청일양화담적함량。상규검측혈청총담고순、감유삼지、저밀도지단백급고밀도지단백적수평。결과치료전,신벌타정간예조(10 mg조、20 mg조、40 mg조)환자혈청NO수평여대조조비교무통계학차이(P>0.05)。치료8주후,신벌타정간예조(10 mg조、20 mg조、40 mg조)환자NO수평현저승고,여치료전비교,유명현통계학차이(P<0.05);여대조조비교유통계학차이(P>0.05)。대조조환자치료전후NO수평무명현변화(P>0.05)。치료전,신벌타정간예조(10 mg조、20 mg조、40 mg조)환자굉동맥내경기출치、FMD급NMD수평여대조조비교균무통계학차이(P>0.05)。치료8주후,신벌타정간예조(10 mg조、20 mg조、40 mg조)환자굉동맥내경기출치、NMD수평여치료전비교,무통계학차이(P>0.05);FMD수평교치료전현저증가,여대조조비교야정명현증가추세,차이유통계학의의(P<0.05);NMD수평여여조조비교,차이무통계학의의(P>0.05)。결론신벌타정가증가관상동맥죽양경화증환자혈청일양화담수평,개선혈관내피세포공능,기작용궤제여개선혈지수평무명현적량효관계。
Objective To observe the influences of simvastatin in different doses on vascular endothelial function in patients with coronary atherosclerosis. Methods The patients (n=133) were divided, according to the level of low-density lipoprotein-cholesterol (LDL-C), into 4 groups: 40 mg group (LDL-C≥4.16 mmol/L, n=30, treated with simvastatin, 40 mg/d), 20 mg group (3.64 mmol/L≤LDL-C<4.16 mmol/L, n=35, treated with simvastatin, 20 mg/d), 10 mg group (2.6 mmol/L≤LDL-C<3.64 mmol/L, n=37, treated with simvastatin, 10 mg/d) and control group (LDL-C<2.6 mmol/L, n=31, not treated with simvastatin). The changes of flow-mediated dilatation (FMD) and nitroglycerin-mediated dilatation (NMD) were detected by using color Doppler ultrasonic diagnostic apparatus. The content of serum nitric oxide (NO) was detected by using nitrate reductase method, and the levels of serum total cholesterol (TC), triglyceride (TG), LDL-C and high-density lipoprotein-cholesterol (HDL-C) were detected conventionally. Results Before treatment, the level of serum NO had no statistical difference in all simvastatin groups compared with control group (P>0.05). After treatment for 8 w, the level of serum NO increased significantly in all simvastatin groups (P<0.05), and had statistical difference compared with control group (P<0.05). The level of NO had no obvious changes in control group before and after treatment (P>0.05). Before treatment, the basis value of brachia diameter, FMD and NMD had no statistical difference between all simvastatin groups and control group (P>0.05). After treatment for 8 w, the basis value of brachia diameter and NMD had no statistical difference in all simvastatin groups (P>0.05) and FMD increased significantly, and the difference was statistically significant compared with control group (P<0.05). The difference in NMD had no statistically significance between all simvastatin groups and control group (P>0.05). Conclusion Simvastatin can increase the level of serum NO, improve vascular endothelial function in patients with coronary atherosclerosis, and there is no dose-effect relationship in its mechanism of ameliorating level of blood fat.