单次大剂量阿托伐他汀改善活动平板诱发的心肌缺血的初步研究  

Preliminary Study of a Single High-dose Atorvastatin Improving the Treadmill Test Induced Myocardial Ischemia in Patients With Stable Angina

作　　者：吴娜琼[1] 张晗晖[1] 郭远林[1] 徐瑞霞[1] 朱成刚[1] 唐熠达[1] 蒋立新[1] 李建军[1] 

机构地区：[1]中国医学科学院北京协和医学院心血管病研究所阜外心血管病医院国家心血管病重点实验室脂代谢异常与心血管疾病诊治中心,北京市100037

出　　处：《中国循环杂志》2014年第5期335-338,共4页Chinese Circulation Journal

基　　金：教育部博士点基金(20111106110013);首都临床应用特色基金部分资助(212 1107001012015)

摘　　要：目的:本研究旨在观察单次应用大剂量阿托伐他汀80 mg于24 h内能否改善活动平板所诱发的心肌缺血,并探讨可能的机制。方法:本研究采用随机、开放、低剂量阿托伐他汀对照的方法,连续入选我院冠心病稳定性心绞痛且活动平板试验阳性的患者33例,随机接受单次大剂量阿托伐他汀80 mg的患者17例(80 mg组),低剂量阿托伐他汀10 mg的患者16例(10 mg组),24 h后再次行活动平板试验,采用ELISA方法检测血浆炎性标志物高敏C反应蛋白(Hs-CRP)、白细胞介素(IL)-6及IL-10、氧化低密度脂蛋白(ox-LDL)和脂蛋白—磷脂酶A2(Lp-PLA2)的浓度。以观察单次大剂量服用阿托伐他汀前后活动平板试验中相关导联所提示的心肌缺血有无改善。结果:服药前后活动平板所提示的心肌缺血相关导联ST段压低最大幅度:80 mg组服药后较服药前降低,差异有统计学意义(P<0.05),10 mg组服药前后变化差异无统计学意义(P>0.05)。10 mg组和80 mg组患者服药前后血浆HsCRP、IL-6和IL-10以及ox-LDL和Lp-PLA2变化差异均无统计学意义(P>0.05)。结论:单次大剂量阿托伐他汀80 mg服用24 h后可改善稳定心绞痛患者活动平板所诱发的心肌缺血,其作用似与炎症因子水平降低无关,详细机制有待进一步探讨。Objective： To study the effect of a single high-dose atorvastatin improving the treadmill test induced myocardial ischemia in patients with stable angina. Methods： A total of 33 consecutive patients of stable angina with positive treadmill test in our hospital were enrolled and randomized into 2 groups. High-dose group, the patients received a single dose of atorvastatin 80mg in 24 hours, n=17 and Low-dose group, the patients received a single dose of atorvastatin 10 mg in 24 hours, n=16. All patients took treadmill test after the medication, the maximum ECG ST segment changes were examined, and plasma inflammatory factors as hs-CRP, IL-6, IL-10 and ox-LDL, LP-PLA2 were measured by ELISA. Results： ① The High-dose group presented significant improvement in ECG ST segment after a single dose treatment than it was before, P〈0.05, and such change in Low-dose group was not obvious, P〉0.05.② The inflammatory factors including hs-CRP, IL-6, IL-10, ox-LDL, LP-PLA2 were similar before and after the treatment in both groups, P〉0.05. Conclusion： A single high-dose atorvastatin medication in 24 hours may improve the treadmill test induced myocardial ischemia in patients with stable angina, the possible mechanism should be further studied.

关 键 词：阿托伐他汀 大剂量 单次 活动平板 心肌缺血 

分 类 号：R541[医药卫生—心血管疾病]