论文部分内容阅读
目的:探讨阿托伐他汀对心血管疾病患者动脉僵硬度的影响。方法:67例心血管疾病患者,其中男性28例,女性39例,平均年龄(62.42±9.41)岁(范围35~80岁)。受检者3例为单纯高脂血症,3例为单纯糖尿病患者,5例为单纯冠心病患者,56例为高血压合并冠心病或糖尿病患者。观察服用阿托伐他汀10 mg治疗4周、12周和24周时血脂水平及动脉僵硬度的改善状况。动脉僵硬度的评价应用脉搏波速度测定系统(pulse wave velocity,PWV)和血压脉搏测量装置。颈动脉-股动脉PWV(C-F PWV)、颈动脉-桡动脉PWV(C-R PWV)和心-踝血管指数(cardio-ankle vascular index,CAVI)作为反映动脉僵硬度改变的指标。结果:阿托伐他汀治疗前与治疗后4周、12周、24周相比总胆固醇水平明显降低[分别为(5.12±1.18)mmol/L,(4.05±0.82)mmol/L,(4.18±0.80)mmol/L和(4.27±1.00)mmol/L,与基线相比,均为P<0.01];低密度脂蛋白胆固醇水平在治疗后显著下降[分别为(2.95±0.92)mmol/L,(2.11±0.64)mmol/L,(1.24±0.24)mmol/L,(1.28±0.29)mmol/L,与基线相比,均为P<0.01];高密度脂蛋白胆固醇水平在治疗12周后明显增加,并持续至24周[分别为(1.33±0.40)mmol/L,(1.24±0.29)mmol/L,(2.22±0.72)mmol/L,(2.31±0.83)mmol/L,与基线相比,均为P<0.01]。C-F PWV治疗后显著下降[分别为(12.33±2.54)m/s,(11.43±2.46)m/s,(11.18±2.05)m/s,(11.14±1.77)m/s,与基线相比,均为P<0.01];C-R PWV治疗12周后明显降低并持续到24周[分别为(10.07±1.89)m/s,(9.71±1.39)m/s,(9.62±1.41)m/s,(9.52±1.33)m/s,与基线相比,均为P<0.01]。CAVI在治疗前后无显著差异。结论:阿托伐他汀治疗可有效降低胆固醇水平,并对改善心血管疾病患者动脉僵硬度有益,对动脉结构的改变需更长期的治疗。
Objective: To investigate the effect of atorvastatin on arterial stiffness in patients with cardiovascular diseases. Methods: Sixty-seven patients with cardiovascular diseases, including 28 males and 39 females, averaged (62.42 ± 9.41) years (range, 35-80 years). The subjects were simple hyperlipidemia in 3 cases, 3 cases of simple diabetes, 5 cases of simple coronary heart disease, 56 cases of hypertension with coronary heart disease or diabetes. To observe the improvement of blood lipids and arterial stiffness in patients treated with atorvastatin 10 mg for 4 weeks, 12 weeks and 24 weeks. Arterial stiffness was evaluated using pulse wave velocity (PWV) and blood pressure pulse measurement devices. C-F PWV, C-R PWV, and cardio-ankle vascular index (CAVI) of carotid-femoral artery were used as indexes to reflect the change of arterial stiffness. Results: The levels of total cholesterol in atorvastatin before treatment were significantly lower than those at 4 weeks, 12 weeks and 24 weeks after treatment (5.12 ± 1.18 mmol / L, 4.05 ± 0.82 mmol / L, 4.18 ± 0.80) mmol / L and (4.27 ± 1.00) mmol / L respectively, both P <0.01 compared with baseline; LDL cholesterol levels decreased significantly after treatment (2.95 ± 0.92 mmol / L, (2.11 ± 0.64) mmol / L, (1.24 ± 0.24) mmol / L and (1.28 ± 0.29) mmol / L respectively, both P <0.01 compared with the baseline). After 12 weeks of treatment, the levels of HDL- (1.33 ± 0.40) mmol / L, (1.24 ± 0.29) mmol / L, (2.22 ± 0.72) mmol / L and (2.31 ± 0.83) mmol / L respectively Ratio, all P <0.01]. Compared with the baseline, CF PWV significantly decreased after treatment (12.33 ± 2.54 m / s, 11.43 ± 2.46 m / s, 11.18 ± 2.05 m / s, 11.14 ± 1.77 m / s, (P <0.01). CR PWV significantly decreased after 12 weeks and lasted for 24 weeks [(10.07 ± 1.89) m / s, (9.71 ± 1.39) m / s and (9.52 ± 1.33) m / s, all P <0.01 compared with baseline). There was no significant difference in CAVI before and after treatment. Conclusion: Atorvastatin treatment can effectively reduce the level of cholesterol, and improve the arterial stiffness in patients with cardiovascular disease benefit, the changes in the structure of the artery need more long-term treatment.