阿托伐他汀逆转动脉僵硬度多中心、开放临床研究  

Multi-center,open label clinical study on regression of arterial stiffness by atorvastatin

作　　者：王宏宇[1,2,3] 张瑞岩[4] 罗建方 王敏 谢俊 房玲 李丽红[1] 刘康 黄健 谭学君 龚兰生[4] 

机构地区：[1]北京大学首钢医院血管中心,北京100144 [2]北京市门头沟区中医医院血管科 [3]贵阳市第三人民医院血管科 [4]上海交通大学附属瑞金医院心内科 [5]广东省人民医院心内科

出　　处：《中国民康医学》2010年第9期1067-1068,1081,共3页Medical Journal of Chinese People’s Health

摘　　要：目的：探讨阿托伐他汀对心血管疾病患者动脉僵硬度的影响。方法：67例心血管疾病患者，其中男性28例，女性39例，平均年龄（62．42±9．41）岁（范围35～80岁）。受检者3例为单纯高脂血症，3例为单纯糖尿病患者，5例为单纯冠心病患者，56例为高血压合并冠心病或糖尿病患者。观察服用阿托伐他汀10nag治疗4周、12周和24周时血脂水平及动脉僵硬度的改善状况。动脉僵硬度的评价应用脉搏波速度测定系统（pulse wave velocity，PWV）和血压脉搏测量装置。颈动脉-股动脉PWV（C—F PWV）、颈动脉-桡动脉PWV（C—R PWV）和心-踝血管指数（cardio—ankle vascular index，CAVI）作为反映动脉僵硬度改变的指标。结果：阿托伐他汀治疗前与治疗后4周、12周、24周相比总胆固醇水平明显降低[分别为（5．12±1．18）mmol／L，（4．05±0．82）mmol／L，（4．18±0．80）mmol／L和（4．27±1．00）mmol／L，与基线相比，均为P〈0．01]；低密度脂蛋白胆固醇水平在治疗后显著下降[分别为（2．95±0．92）mmol／L，（2．11±0．64）mmol／L，（1．24±0．24）mmol／L，（1．28±0．29）mmol／L，与基线相比，均为P〈0．01]；高密度脂蛋白胆固醇水平在治疗12周后明显增加，并持续至24周[分别为（1．33±0．40）mmol／L，（1．24±0．29）mmol／L，（2．22±0．72）mmol／L，（2．31±0．83）mmol／L，与基线相比，均为P〈0．01]。C—F PWV治疗后显著下降[分别为（12．33±2．54）m／s，（11．43±2．46）m／s，（11．18±2．05）m／s，（11．14±1．77）m／s，与基线相比，均为P〈0．01]；C—R PWV治疗12周后明显降低并持续到24周[分别为（10．07±1．89）m／s，（9．71±1．39）m／s，（9．62±1．41）m／s，（9．52±1．33）m／s，与基线相比，均为P〈0．01]。CAVI在治疗前后无显著差异。结论：阿托伐他汀治疗可有效降低胆固醇水平，并对Objective：To explore the effect of atorvastatin on arterial stiffness in patients with cardiovascular disease. Methods：67 cases of cardiovascular disease patients included in our study,28 male,39 female, mean age was 62.42 ± 9.41years old（ range 35 -80years old）, arterial function were examined at baseline ,4 weeks, 12 weeks and 24 weeks of atorvastatin therapy. Automatic PWV measurement system and blood pressure - pulse measurement device were used to evaluate arterial function, C - FPWV, C - RPWV and CAVI used as parameters to reflect arterial function. Results： Atorvastatin could reduce total cholesterol after 4 weeks, 12 weeks and 24 weeks therapy（5.12 ± 1.18mmol/L,4.05 ±0. 82mmol/L,4.18 ±0.80mmol/L and 4.27 ± 1.00mmol/L, compared to baseline, all were P 〈 0.01 ） ;low density cholesterol decreased significandy （2.95 ± 0.92mmol/L, 2.11 ± 0.64mmol/L, 1.24±0.24mmol/L, 1.28 ±0.29mmol/L,eompared to baseline ,all were P 〈 0.01 ） ;high density cholesterol increased significantly after 12 weeks and 24 weeks therapy（ 1.33 ± 0.40mmol/L, 1.24±0.29mmol/L, 2.22± 0.72mmol/L, 2.31± 0.83mmol/L, compared to baseline, all were P 〈 0. 01 ）. C -F PWV decreased significantly after 4 weeks, 12 weeks and 24 weeks therapy（ 12.33 ± 2.54m/s, 11.43 ± 2.46m/s, 11.18 ± 2.05m/s, 11.14 ± 1.77m/s, compared to baseline, all were P 〈 0.01 ） ; C - R PWV decreased significantly after 4 weeks, 12 weeks and 24 weeks therapy（ 10.07± 1.89m/s,9.71± 1.39m/s ,9.62±1.41m/s,9.52 ±1.33m/s, compared to baseline, all were P 〈 0.01 ）. CAVI had no significant difference after 24 weeks therapy. Conclusions： Atorvastatin could effectively reduce cholesterol level and improve arterial function in patients with cardiovascular disease, for improving arterial structural damage will need longer therapy.

关 键 词：动脉僵硬度 阿托伐他汀 临床研究 心血管疾病患者 多中心 胆固醇水平 治疗前后 心-踝血管指数 

分 类 号：R54[医药卫生—心血管疾病]