摘要
目的探讨阿托伐他汀对冠状动脉慢血流(CSF)患者血脂、血管内皮功能及治疗效果的影响。方法选择2012年5月至2014年9月在延安市人民医院就诊的75例CSF患者为研究对象,采用随机数字表法将患者分为常规治疗组(37例)和阿托伐他汀组(38例)。常规治疗组给予常规治疗:阿司匹林每日100 mg口服、单硝酸异山梨酯每日20 mg口服,合并高血压或糖尿病者给予降脂和降糖治疗,阿托伐他汀组在常规治疗组的基础上给予阿托伐他汀每日10 mg口服治疗。两组患者均治疗4周。比较两组患者的血脂水平、内皮功能以及疗效。结果治疗后,阿托伐他汀组患者三酰甘油、总胆固醇、低密度脂蛋白胆固醇、载脂蛋白B水平明显低于常规治疗组[(2.3±0.4)mmol/L比(3.3±0.5)mmol/L、(4.0±0.5)mmol/L比(4.9±0.6)mmol/L、(1.78±0.18)mmol/L比(2.38±0.29)mmol/L、(0.89±0.08)g/L比(1.22±0.18)g/L],高密度脂蛋白胆固醇、载脂蛋白AⅠ水平明显高于常规治疗组[(1.89±0.22)mmol/L比(1.33±0.16)mmol/L,(1.55±0.22)g/L比(1.23±0.14)g/L](P<0.05);阿托伐他汀组患者左前降支、左回旋支、右冠状动脉的心肌梗死溶栓试验帧数均明显少于常规治疗组[(34.0±4.2)比(42.6±4.4)、(36.1±4.4)比(45.7±4.7)、(33.5±3.7)比(40.1±4.2)](P<0.01);阿托伐他汀组患者血浆内皮素1的水平明显低于常规治疗组[(68.1±7.3)ng/L比(105.3±12.5)ng/L],一氧化氮水平明显高于常规治疗组[(56.8±6.7)μmol/L比(41.5±4.6)μmol/L],差异均有统计学意义(P<0.01)。结论阿托伐他汀能够改善血脂代谢,加快血流速度,保护内皮功能,是治疗CSF的理想药物。
Objective To study the effect of atorvastatin on blood fat and vascular endothelium function of patients with coronary slow flow（CSF）. Methods Total of 75 patients with CSF in Yan＇an People＇s Hospital from May 2012 to Sep. 2014 were included in the study and divided into a conventional therapy group （37 cases） and an atorvastatin group （38 cases） according to random number table method. The conventional therapy group was given conventional treatment,aspirin daily 100 mg per oral,20 mg oral administration of isosorbide mononitrate, patients complicated with hypertension or diabetes were given blood lipid and hypo- glycemic treatment. On the basis of the conventional therapy group＇s regimen,the atorvastatin group was given atorvastatin 10 mg daily per oral. Both of the groups were treated for 4 weeks, and blood lipid levels,endothelial function and efficacy of the two groups were compared before and after treatment. Results After treatment ,the triacylglycerol, total cholesterol, low density lipoprotein cholesterol and apolipoprotein B levels of the atorvastatin group were significantly lower than the conventional therapy group[ （2.3 ±0. 4） mmol/L vs （3.3±0.5） retool/L,（4.0±0.5） mmol/L vs （4.9±0.6） mmol/L,（1.78 ±0. 18） mmol/L vs （2.38± 0. 29） retool/L, （0. 89 ± 0. 08 ） g/L vs （1.22 ± 0. 18 ） g/L ] ;the levels of high density lipoprotein cholesterol and apolipopretein A I were significantly higher than the conventional therapy group [ （1.89 ± 0. 22） mmol/L vs （ 1.33 ±0. 16） mmol/L, （ 1.55 ±0. 22） g/L vs （ 1.23 ±0. 14） g/L] （P 〈0.05 ） ;TIMI frames of left anterior descending artery, left circumflex and right coronary artery in the atorvastatin group were significantly less than the conventional therapy group [ （ 34. 0 ± 4. 2 ） vs （ 42.6 ± 4. 4 ）, （ 36. 1± 4.4） vs （45.7±4. 7）, （33.5 ±3.7） vs （40. 1 ±4. 2） ] （P 〈0. 01 ） ;the plasma endothelin-1 of the canventional therapy group was lower than the atorvastatin group[ （68. 1 ±7. 3 ） ng/L vs （105.3 ± 12. 5） ng/L], NO was higher than the atorvastatin group [ （ 56. 8 ± 6. 7 ） μmol/L vs （41.5 ± 4.6 ） μmol/L ], the differences had statistical significance （ P 〈 0. 01 ）. Conclusion Atorvastatin can improve lipid metabolism, accelerate blood flow velocity,and protect endothelial function,thus is an ideal drug therapy for CSF.
出处
《医学综述》
2016年第19期3918-3921,共4页
Medical Recapitulate
