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目的评价阿托伐他汀对急性心肌梗死溶栓患者内皮功能的作用。方法将72例急性心肌梗死溶栓再通患者随机分为治疗组(41例)和对照组(31例)。两组患者常规给以硝酸酯类药物、β受体阻滞剂、血管紧张素转换酶抑制剂、阿司匹林和低分子肝素等药物治疗,治疗组在此基础上,加用阿托伐他汀20mg,1次/晚,疗程为3个月;应用酶联免疫吸附试验(ELISA)检测两组患者溶栓前、溶栓后1d、溶栓后1、2、3个月外周血清中血管内皮素-1(ET-1)、内皮型一氧化氮合酶(e NOS)含量。结果溶栓前和溶栓后1d两组患者血清e NOS水平比较差异无统计学意义(P>0.05),治疗组溶栓后1、2、3个月与对照组比较,血清e NOS水平明显升高(P<0.01);溶栓前和溶栓后1d两组患者血清ET-1水平比较差异无统计学意义(P>0.05),治疗组溶栓后l、2、3个月与对照组比较,血清ET-1水平显著降低(P<0.01)。结论阿托伐他汀对ET-1和e NOS有良好的调节作用,可以减少急性心肌梗死溶栓患者内皮的损伤,有保护血管内皮的作用。
Objective To evaluate the effect of atorvastatin on endothelial function in thrombolytic patients with acute myocardial infarction. Methods Thirty-two patients with thrombolytic recanalization of acute myocardial infarction were randomly divided into treatment group (41 cases) and control group (31 cases). Two groups of patients were routinely given nitrates, beta blockers, angiotensin converting enzyme inhibitors, aspirin and low molecular weight heparin and other drugs, the treatment group on this basis, plus atorvastatin 20mg, 1 / night, the course of treatment was 3 months; ELISA, the two groups of patients before thrombolysis, 1 d after thrombolysis, 1, 2, and 3 months after thrombolysis in peripheral blood serum endothelin- 1 (ET-1), endothelial nitric oxide synthase (eNOS) content. Results There was no significant difference in serum e NOS levels between the two groups before thrombolysis and one day after thrombolysis (P> 0.05). Compared with the control group, the level of eNOS in serum of the treatment group was significantly higher than that of the control group (P <0.01). There was no significant difference in serum ET-1 level between the two groups before thrombolysis and one day after thrombolytic therapy (P> 0.05) Compared with the control group, serum ET-1 level decreased significantly (P <0.01). Conclusions Atorvastatin has a good regulatory effect on ET-1 and eNOS, which can reduce endothelial damage in patients with thrombolytic therapy of acute myocardial infarction and protect vascular endothelium.