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目的:观察强化降脂对冠心病患者血管内皮功能和颈动脉内膜中层厚度(CIMT)的影响。方法:随机将148例冠心病病人分为阿托伐他汀10mg·d~(-1)组72例及强化降脂40mg·d~(-1)组76例,分别于用药前及用药6个月后采空腹静脉血,测定总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)。观察CIMT及血流介导内皮依赖性舒张功能(FMD)的变化。结果:强化降脂组,CIMT由用药前1.52±0.19mm,降至用药6个月时的1.42±0.20mm(P<0.05),较常规剂量组(1.52±0.19mm与1.51±0.19mm)有更显著的效果。两组FMD升高,TC、LDL-C水平降低(P<0.05),40mg组比10mg组更明显。结论:强化降脂治疗能更有效地降低TC和LDL-C水平,改善内皮功能,降低冠心病患者CIMT,并具有良好的安全性。
Objective: To observe the effects of lipid-lowering therapy on vascular endothelial function and carotid artery intima-media thickness (CIMT) in patients with coronary heart disease. Methods: A total of 148 patients with coronary heart disease were randomly divided into atorvastatin 10 mg · d -1 group (n = 72) and intensive lipid-lowering 40 mg · d -1 group (n = 76) Fasting venous blood was taken after the month to measure total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and triglyceride (TG). To observe the changes of CIMT and blood flow-mediated endothelium-dependent relaxation (FMD). Results: In the intensive lipid-lowering group, CIMT decreased from 1.52 ± 0.19mm before treatment to 1.42 ± 0.20mm at 6 months (P <0.05), compared with 1.52 ± 0.19mm and 1.51 ± 0.19mm More significant effect. FMD increased, TC and LDL-C levels decreased in both groups (P <0.05), 40mg group was more obvious than 10mg group. Conclusion: Intensive lipid-lowering therapy can reduce TC and LDL-C levels, improve endothelial function, reduce CIMT in patients with coronary heart disease, and have good safety.