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目的 观察心肌梗死急性期降脂治疗对内皮依赖性血管舒张功能的作用。方法 采用超声法检测 39例急性心肌梗死 (AMI)患者和 31例无心肌梗死者肱动脉内皮依赖性舒张功能。应用随机、交叉实验设计 ,将 39例AMI受试者随机分为单纯常规治疗组和加服辛伐他汀 5mg/d或 10mg/d治疗组 ,治疗 2个月后复测其肱动脉内皮依赖性舒张功能。然后交叉 ,即单纯常规治疗组加服辛伐他汀 5mg/d或 10mg/d ;原服辛伐他汀治疗组停用 ,仅接受常规治疗 ;第 4个月再次检测肱动脉内皮依赖性舒张功能。结果 AMI患者肱动脉内皮依赖性舒张功能 [n =39,(2 .44± 3.31) % ]较对照组 [n=31,(8.13± 4.77) % ]明显降低 (P <0 .0 0 1)。AMI患者服用 5mg/d辛伐他汀 (n =19)治疗 2个月后 ,肱动脉内皮依赖性舒张功能 (4 .2 9± 2 .91) %与治疗前基础水平 (2 .5 4± 2 .5 2 ) %、常规治疗后 (2 .89±3.71) %相比差别无显著性 ;而服用 10mg/d ,辛伐他汀 (n =2 0 )治疗 2个月后 ,肱动脉内皮依赖性舒张功能 [(6 .2 4± 4.14) % ]与治疗前基础水平 [(2 .35± 3.92 ) %P <0 .0 1]、常规治疗后 [(2 .5 7± 3.5 7) %P <0 .0 5 ]相比 ,有显著性改善。同时还观察到 ,与常规治疗相比较 ,辛伐他汀 (5mg/d或 10mg/d)治疗后血总胆固醇水平有明显降低。结论
Objective To observe the effect of lipid-lowering therapy in acute myocardial infarction on endothelium-dependent vasodilatation. Methods The brachial artery endothelium-dependent vasodilatation in 39 patients with acute myocardial infarction (AMI) and 31 patients without myocardial infarction was detected by ultrasound. A randomized, crossover experimental design, 39 AMI subjects were randomly divided into conventional treatment group and simvastatin 5mg / d or 10mg / d treatment group, after 2 months of retest its brachial artery endothelium-dependent Diastolic function. And then crossed, that is, the simple routine treatment group plus simvastatin 5mg / d or 10mg / d; the original service simvastatin treatment group discontinued, only conventional treatment; the fourth month of retest brachial artery endothelium-dependent relaxation. Results Compared with the control group [n = 31 (8.13 ± 4.77)%], the brachial artery endothelium-dependent diastolic function in patients with AMI was significantly lower than that in the control group [n = 39,244 ± 3.31% . After 2 months of treatment with simvastatin 5 mg / d (n = 19) in AMI patients, the endothelium-dependent vasodilation of brachial artery (4.29 ± 2.91%) was significantly lower than that of pretreatment baseline (2.54 ± 2 .5 2)%, there was no significant difference between the two groups (2.89 ± 3.71)% after conventional treatment; while after taking 10mg / d and simvastatin (n = 20) for 2 months, the brachial artery endothelium dependent (2.24 ± 4.14)%] and pre-treatment basal level [(2.35 ± 3.92)% P <0.01), and after conventional treatment [(2.57 ± 3.57)% P <0. 0 5] compared to significant improvement. Simultaneously, it was also observed that there was a significant reduction in blood total cholesterol levels after simvastatin (5 mg / day or 10 mg / day) compared with conventional treatment. in conclusion