辛伐他汀对冠心病患者血管内皮功能作用的量效关系  

Dose-effect relationship of simvastatin on vascular endothelial function in patients with coronary heart disease

作　　者：曾武涛[1] 黄润莲 冷秀玉[1] 刘东红[1] 杨波[1] 卢集森 陈科奇 陈国伟[1] 

机构地区：[1]中山大学附属第一医院,广东广州510080 [2]广州市荔湾区中医医院,广东广州510160 [3]深圳市人民医院,广东深圳518020

出　　处：《中国心血管杂志》2007年第1期13-16,共4页Chinese Journal of Cardiovascular Medicine

基　　金：广州市科委基金资助课题(编号:2002105)

摘　　要：目的探讨不同剂量(5mg,10mg,20mg)的辛伐他汀对冠心病患者血管内皮功能的作用及其量效关系。方法共入选80例冠心病患者,随机分为4组:对照组(不服用辛伐他汀),辛伐他汀5 mg组、辛伐他汀10 mg组、辛伐他汀20 mg组、每组20例,治疗8周。采用超声法检测血流介导的肱动脉内皮依赖性舒张功能(FMD),同时观察血脂水平的变化。结果辛伐他汀治疗8周后,5 mg、10 mg、20 mg呈剂量依赖性显著降低血总胆固醇(分别降低9%,18%,29%)和低密度脂蛋白胆固醇水平(分别降低12%、24%、35%),不同剂量组间P<0.05。对照组治疗8周后血脂水平无明显变化(P>0.05)。5 mg、10 mg、20 mg的辛伐他汀均可显著改善FMD[5mg:(3.41±2.99)%VS(7.46±5.11)%;10mg:(3.76±3.01)%比(7.98±4.92)%;20mg:(3.59±3.47)%比(8.09±6.10)%;P均<0.01]。但三组之间FMD的变化值比较无显著差异(P>0.05),且FMD的改善与血TC、LDL-C水平的降低不相关。对照组FMD虽有轻度增加,但无统计学意义。辛伐他汀治疗后肱动脉内径、肱动脉对硝酸甘油的反应均无显著改变。结论辛伐他汀5 mg、10 mg、20 mg治疗8周后,可显著改善冠心病患者血管内皮功能,但该作用无明显的量效关系,可能独立于调脂作用之外。Objective To explore the effects and dose-effect relationship of various doses of simvastatin including 5mg, 10mg, 20mg/day to vascular endothelial function in patients with coronary heart disease（CHD）. Methods Total 80 patients with CHD were included and randomly divided into four groups： Control group（no simvastatin） and simvatatin groups of various groups（5mg/day, 10mg/day, 20mg/day）, 20 patients in each group. The endothelial dependent flux modulated dilation（FMD） of brachial artery was measured by ultrasound technique before and after 8 weeks treatment. At the same time, the changes of lipids were examined. Results After 8 weeks treatment, 3 simvastatin groups（5mg, 10rng, 20mg） apparently reduced the serum level of TC（9%, 18%, 29%, respectivdy） and the serum level of LDL-C（12%, 24% ,35% ,respectively）. The values of P among different dose groups comparison were all less than 0.05. The serum levels of lipids in control group did not significantly change after therapy. The values of FMD apparently increased in 3 simvastatin groups（5mg： 3.41 ±2.99%vs 7.46±5.11%; 10mg： 3.76±3.01%vs 7.98±4.92%;20mg：3.59±3. 47 % vs 8.09 ± 6.10 % ; P 〈 0.01 ）. But there was no statistic difference among them. The increase of FMD did not relate to the changes of TC and LDL-C level in the serum. Although the value of FMD slightly increased in control group, it had no statistic significance. There was no significant change of vasodilation response to nitroglycerin and brachial diameter in all groups after simvastatin therapy. Conclusion Various doses of simvastatin（ 5mg, 10mg, 20mg） can obviously improve the vascular endothelial function of patients with CHD in 8 weeks. But it has no obvious dose effect relationship and it may not relate to lipid-lowering action.

关 键 词：辛伐他汀 冠心病 血管内皮功能 

分 类 号：R541.4[医药卫生—心血管疾病]