瑞舒伐他汀对冠状动脉血流缓慢的糖尿病患者冠状动脉血流储备的影响  

Impact of Rosuvastatin on coronary flow reserve in patients with diabetes and coronary slow flow

作　　者：王芳[1] 吴红玲[1] 黄镇河[1] 凌云[1] 徐明明[1] 

机构地区：[1]广东省深圳市南山区人民医院VIP病房,广东深圳518052

出　　处：《中国医药导报》2012年第4期46-48,共3页China Medical Herald

摘　　要：目的探讨瑞舒伐他汀对冠状动脉血流缓慢的糖尿病患者冠状动脉血流储备(CFR)的影响。方法选择有胸痛症状的初次发现糖尿病患者(6%<糖化血红蛋白<8%)61例,其冠状动脉造影结构正常但伴有冠状动脉血流缓慢现象(CSFP),分为治疗组35例和无治疗组26例。全部糖尿病患者均口服二甲双胍(0.25 g,1日3次)6周,治疗组给予口服瑞舒伐他汀(10 mg,1日1次)6周。另外选择20例冠状动脉造影正常且无CSFP的无心脏病及糖尿病者为正常对照组。治疗前后测定治疗组及无治疗组的空腹血糖、血脂,并利用腺苷负荷超声记录左前降支远端血流频谱,评价CFR的改变。结果口服瑞舒伐他汀6周后,治疗组总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)明显低于无治疗组及正常对照组(P<0.05);而高密度脂蛋白胆固醇(HDL-C)高于无治疗组,与正常对照组比较差异无统计学意义(P>0.05);口服二甲双胍后,治疗组及无治疗组空腹血糖较治疗前明显降低(P<0.05),与正常对照组比较差异无统计学意义(P>0.05)。给予瑞舒伐他汀治疗前,治疗组及无治疗组CFR均低于正常对照组(P<0.05);治疗6周后,治疗组较治疗前及无治疗组,静息状态下冠状动脉血流速度较低,最大冠状动脉扩张状态下血流速度和CFR较高(均P<0.05)。结论伴有CSFP的糖尿病患者早期应用他汀类药物,在调节血脂的同时,可以改善其CFR,且该作用独立于降糖作用之外。Objective To investigate the impact of Rosuvastatin on coronary flow reserve in patients with diabetes and coronary slow flow.Methods A total of 61 patients with incipient diabetes（6%HbA1c8%）,chest pain and coronary slow flow phenomenon（CSFP） but normal coronary angiography were included in this study.Patients were divided into treatment group（Rosuvastatin 10 mg/d for 6 weeks,n = 35） and non-treatment group（Metformin 750 mg/d for 6 weeks,used in all the patients,n = 26）.20 healthy subjects with normal angiography and coronary flow were served as normal controls.Fasting blood glucose（FBG） and lipid were measured.Doppler coronary flow velocity and Doppler reserve measurement of distal left anterior descending were recorded at rest and adenosine infusion induced hyperemia state.Coronary flow reserve（CFR） was calculated before and after Rosuvastatin treatment.Results 6 weeks later,total cholesterol and LDL-C levels were significantly lower in statin group than in non-statin group and control group,HDL-C level was significantly higher in statin group than in non-statin group（P 0.05）,and it was similar to that of control group（P 0.05）.After Metformin treatment,FBG levels of statin group and non-statin group were significant lower than before（P 0.05）.Baseline CFR levels were significantly lower in statin group and non-statin group than that in control group before Rosuvastatin treated.Compared with non-statin group and statin group before treatment,6 weeks statin treatment was associated with reduced bCFV,increased hCFV and increased CFR.Conclusion Early statin use on patients with diabetes and CSFP can improve their blood lipid and CFR.This effect is independent of glucose-lowering effect.

关 键 词：慢血流现象 糖尿病 他汀类降脂药 冠状动脉血流储备 

分 类 号：R543[医药卫生—心血管疾病]