辛伐他汀降脂治疗对老年人血管内皮功能及颈动脉内膜—中膜厚度的影响  

Effects of Simvastatin on Endothelial Function and Intima-media Thickness of Carotid Arteries in Elderly Patients

作　　者：苏琳[1] 苗懿德[1] 孙宁玲[2] 周惠清[2] 张万蕾[3] 

机构地区：[1]北京大学人民医院老年科,北京100044 [2]北京大学人民医院心血管研究所,北京100044 [3]北京大学人民医院超声室,北京100044

出　　处：《中国动脉硬化杂志》2001年第5期420-423,共4页Chinese Journal of Arteriosclerosis

摘　　要：了解辛伐他汀降脂治疗对老年人血管内皮依赖性舒张功能、颈动脉内膜—中膜厚度的影响 ,采用高分辨率超声技术检测 2 0例对照者、2 0例原发性高胆固醇血症及 2 0例冠心病伴高胆固醇血症患者降脂治疗前后血管内皮依赖性舒张功能及颈动脉内膜—中膜厚度的变化。结果发现 ,与对照组比较 ,原发性高胆固醇血症患者及冠心病伴高胆固醇血症患者肱动脉血流介导性舒张明显减弱 ,颈动脉内膜—中膜厚度明显增加。服用辛伐他汀 2 0mg d ,治疗 3～ 4月后 ,原发性高胆固醇血症患者及冠心病伴高胆固醇血症患者血浆总胆固醇明显下降 ,肱动脉内皮依赖性舒张较治疗前明显改善 ,但仍低于对照组。治疗前后颈动脉内膜—中膜厚度无显著性改变。提示老年单纯高胆固醇血症及合并冠心病患者存在内皮功能障碍 ,经辛伐他汀降脂治疗后 ,血管内皮依赖性舒张功能明显改善 ,但颈动脉内膜—中膜厚度无明显改善。Aim To investigate the effect of simvastatin on endothelium dependent relaxing function, intima-media thickness (IMT) of carotid in elderly patients. Methods With high-resolution ultrasound, before and after simvastatin treatment, endothelium dependent relaxing function and IMT of carotid arteries were measured in 60 subjects: 20 with primary hypercholesterolemia, 20 with coronary heart disease and hypercholesterolemia and 20 controls. Results In elderly patients, IMT of carotid arteries was higher and flow-mediated dilatation was much reduced compared with that of control group. After therapy with simvastatin 20 mg/d for 3～4 months, total cholesterol, triglyceride, low density lipoprotein cholesterol(LDLC) and high density lipoprotein cholesterol(HDLC) were much reduced, and flow-mediated vasodilation was improved than before, though it was still lower than control group. There was no significant changes of IMT. Conclusions Endothelium dependent vasodilation was impaired in elderly hypercholesterolemia patients, whose IMT of carotid arteries was increased. Simvastatin improves impaired endotheliumdependent vasodilatation, but with little effect on increased IMT of carotid arteries.

关 键 词：高胆固醇血症 冠状动脉疾病 动脉粥样硬化 血管内皮 治疗 

分 类 号：R543.05[医药卫生—心血管疾病]