阿托伐他汀强化治疗对冠状动脉血流缓慢综合征患者的影响  

Effect of intensive atorvastatin therapy on coronary slow flow syndrome

作　　者：梁健球[1,2] 吴剑弟[3] 黄永光[3] 王玉燕[3] 欧小敏[3] 许顶立[1] 

机构地区：[1]南方医科大学南方医院心血管内科,广州510515 [2]佛山第二人民医院心内科 [3]佛山市第二人民医院心内科ICU

出　　处：《中华老年心脑血管病杂志》2012年第5期460-463,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：广东省“211工程”三期重点学科建设项目“器官衰竭防治研究”专项资金资助(2011-948)

摘　　要：目的观察阿托伐他汀强化治疗对冠状动脉血流缓慢(SCF)综合征患者的影响。方法选择28例经冠状动脉造影确诊为SCF综合征的患者为SCF组,口服阿托伐他汀40 mg/d,25例冠状动脉血流正常(NCF)患者作为NCF组。治疗前后,分别检测2组TC、LDL-C、HDL-C、高敏C反应蛋白(hs-CRP)、细胞间黏附分子1(ICAM-1)、血管细胞黏附分子1(VCAM-1)、E选择素;采用超声检测肱动脉血流介导的内皮依赖性血管舒张功能(FMD)和硝酸甘油治疗的非内皮依赖性血管舒张功能(NMD),以冠状动脉血流计帧值法(Timi-FC)评价造影时冠状动脉血流速度。结果与治疗前比较,治疗4周后SCF组Timi-FC、TC、LDL-C、hs-CRP、ICAM-1、VCAM-1及E选择素显著降低(P<0.05),FMD及NMD显著升高(P<0.01);与NCF组比较,hs-CRP、ICAM-1、VCAM-1、E选择素、FMD及NMD无显著差异;与治疗前比较,NCF组随访4周后TC、LDL-C显著降低(P<0.05);Timi-FC与hs-CPC、ICAM-1、VCAM-1和E选择素呈正相关(P<0.01),与FMD、NMD呈负相关(P<0.01)。结论 SCF与血管内皮功能及炎性反应密切相关,他汀类药物强化治疗可降低炎性反应,改善血管内皮功能,提高冠状动脉血流速度。Objective To observe the effect of intensive atorvastatin therapy on slow coronary flow（SCF） syndrome.Methods Twenty-eight patients with SCF syndrome served as SCF group and 25 subjects with normal coronary flow（NCF） served as NCF group.Patients in SCF group were treated with oral atorvastatin（40 mg/d） for 4 weeks.Serum levels of TC,LDL-C,HDL-C,hs-CRP,ICAM-1,VCAM-1,E-selectin were measured,blood flow-mediated FMD and nitroglycerol-mediated NMD were detected by ultrasonography 4 weeks before and after treatment.Coronary flow rate was measured with Timi-FC.Results The levels of Timi-FC,TC,LDL-C,hs-CRP,ICAM-1,VCAM-1 and Eselectin were significantly lower while the FMD and NMD were significantly higher in SCF group than in NCF group 4 weeks after treatment than before treatment（P〈0.05）.No significant difference was found in hs-CRP,ICAM-1,VCAM-1,E-selectin,FMD and NMD between the two groups.The levels of TC and LDL-C were significantly lower in NCF group 4 weeks after treatment than before treatment（P〈0.05）.The TimiFC was positively related with hs-CRP,ICAM-1,VCAM-1 and E-selectin and negatively related with FMD and NMD（P〈0.01）.Conclusion SCF syndrome is closely related with decreased vascular endothelial function and inflammatory response.Intensive atorvastatin therapy can decrease serum level of inflam-matory factors,improve vascular endothelial function and coronary flow rate in patients with SCF syndrome.

关 键 词：冠状动脉疾病 血流速度 冠状血管造影术 胆固醇 LDL 胆固醇 HDL C反应蛋白质 血管细胞黏附分子1 

分 类 号：R543.3[医药卫生—心血管疾病]