辛伐他汀对X综合征心功能储备及内皮功能的影响  

Effect of simvastatin on the reserve of heart function and endothelial function in X-syndrome

作　　者：谢雄伟[1] 庄汉屏[1] 唐凤英[2] 姚佳梅[1] 

机构地区：[1]中南大学湘雅医院老干科,长沙410008 [2]中南大学湘雅二医院肾内科,长沙410011

出　　处：《中南大学学报（医学版）》2008年第8期700-704,共5页Journal of Central South University ：Medical Science

基　　金：湖南省教育厅科学研究重点资助项目(湘财[2006]36号)~~

摘　　要：目的:研究辛伐他汀与传统药物相结合对伴心功能储备减低的心脏X综合征患者的心功能储备及内皮功能的影响。方法:2006年9月至2007年9月在湘雅医院临床拟诊心脏X综合征的患者40例进行临床资料分析,随机分为辛伐他汀治疗组和对照治疗组,每组20例,对照治疗组常规给予β受体阻滞药、钙通道阻滞药或长效硝酸酯类治疗,辛伐他汀治疗组在对照治疗组基础上联合辛伐他汀40mg,每晚1次,治疗12周后,观察临床情况并复查平板运动试验,设20例体检健康者作为对照组。3组均进行运动平板试验,静脉抽血检测血脂、血清内皮素-1(ET-1)、血清NO水平及血压和体质量。结果:辛伐他汀治疗组疼痛发作次数较治疗前显著减少,ET-1水平、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)水平和ET-1/NO显著降低,血清高密度脂蛋白(HDL-C)及血清NO水平显著升高,运动终点时间显著延长;与对照治疗组治疗后比较,疼痛次数明显减少,TG、TC、血清ET-1水平及ET-1/NO明显降低,达到运动终点时间、运动当量、血清NO及HDL-C明显升高;疼痛次数与ET-1/NO呈正相关,与运动终点时间及运动当量呈负相关。结论:辛伐他汀对心脏X综合征患者有较好的临床缓解作用,能有效地改善患者的心功能储备能力和血管内皮功能。Objective To determine the therapeutic effect of simvastatin combined with tradi- tional medicine on patients with X-syndrome, and on the reserve of heart function and endothelial function. Methods Forty patients with X-syndrome were recruited from September 2006 to September 2007 and randomly divided into 2 groups （ a simvastatin group and a control group ） . The control group received routine treatment including 13 receptor blocker, calcium-channel blocker （CCB） and long active nitrate. The simvastatin group received simvastatin and the rountine treatment. The clinical condition and exercise test （TET） were performed before and after the treatment. The levels of triglyeride （TG）, total cholesterol （TC）, low density lipoprotein （LDL-C）, high density lipoprotein （HDL-C）, endothelin-1 （ET-1） and nitric oxide （NO） were measured. Results The frequencies of chest pain in the simvastatin group were lower than those in the control group. The levels of ET-1,ET-1/NO, TG, TC, and LDL-C were significantly decreased in the simvastatin group as compared with the control group after the treatment. The levels of HDL-C and NO were significantly increased in the simvastatin group as compared with the control group after the treatment. The time in TET was significantly increased in the simvastatin group as compared with the control group. The frequencies of chest pain were positively related to the level of ET-1/NO and negatively related to the time in TET. Conclusion Simvastatin is effective for patients with X-syndrome and may improve the endothelial function and the reserve of heart function.

关 键 词：辛伐他汀 X综合征 心功能储备 内皮功能 

分 类 号：R541.4[医药卫生—心血管疾病]