急性冠状动脉综合征患者降胆固醇治疗对内皮依赖性血管舒张功能、血小板及纤溶活性的影响  

Effect of cholesterol-lowering therapy on endothelium-dependent vasodilatation function and platelet activation, plasminogen activator inhibitor-1 in the patients with acute coronary syndromes

作　　者：罗助荣[1] 盖晓波[1] 郑卫星[1] 林毅[1] 李慧忠[2] 郑德柱 陈孟扬 

机构地区：[1]解放军福州总医院心内科,福州市350025 [2]解放军福州总医院心脏彩超室,福州市350025 [3]全军医学检验中心流式细胞研究室 [4]福建省心血管病研究所

出　　处：《中华心血管病杂志》2001年第9期542-545,共4页Chinese Journal of Cardiology

摘　　要：目的　探讨急性冠状动脉综合征降低胆固醇水平后对内皮依赖性血管舒张功能、血小板表面活性颗粒膜蛋白 (CD63 )、溶酶体膜蛋白 (CD62P)及血浆纤溶酶原激活物抑制物 1(PAI 1)的影响。方法　 70例急性冠状动脉综合征患者随机分成普伐他汀治疗组 (普伐他汀组 ) 3 8例及常规治疗组 (常规组 ) 3 2例 ,比较观察治疗 6周前后应用超声检测肱动脉流量介导性扩张 (FMD)的血管内皮舒张功能 ,血小板CD63、CD62P含量及血浆PAI 1、内皮素 1(ET 1)水平的变化。结果　 ( 1)治疗前两组比较 ,内皮依赖性血管舒张功能差异无显著性 [( 4 .91± 0 .81) %与 ( 4 .93± 0 .86) %,P >0 .0 5 ];治疗 6周后 ,常规组内皮依赖性血管舒张功能较治疗前差异无显著性 [( 5 .2 5± 0 .77) %与 ( 4 .93± 0 .86) %,P >0 .0 5 ],而普伐他汀组治疗后差异有十分显著性 [( 6.92± 0 .94 ) %与 ( 4 .91± 0 .81) %,P <0 .0 1]。( 2 )普伐他汀组治疗 6周后血小板CD63、CD62P及血浆PAI 1、ET 1各项指标较治疗前 [( 15 .4 8± 3 .94 ) %、( 14 .97± 3 .2 4 ) %、( 11.73± 3 .18)Au/ml、( 5 .97± 2 .84 )ng/L]均有不同程度降低 [( 10 .12± 2 .92 ) %、( 10 .4 6± 3 .4 5 ) %、( 8.12± 2 .72 )Au/ml、( 3 .2 8± 1.85 )ng/L ,P <0 .0 1]。结?Objective To study the effects of cholesterol-lowering therapy on vascular endothelial function and platelet activation factor CD63?CD62P and plasminogen activator inhibitor-1(PAI-1) in acute coronary syndromes.Methods 70 patients with acute coronary syndromes were randomly divided into pravastation therapeutic group (n=38)or conventional therapeutic group (n=32). Vascular endothelial function ,in form of flow-mediated dilatation (FMD), was assessed in the brachial artery by high-resolution ultrasound technique. The levels of platelet CD63 and CD62P, plasma PAI-1 and plasma endothelin-1(ET-1) were assayed before and 6 week after therapy in two groups. Results (1) Before the therapy,the comparisons of FMD parameters between the two groups had no significant difference group[(4.91±0.81)% vs (4.93±0.86)%, P>0.05]. After 6 weeks of therapy, FMD was unchanged in conventional [(4.93±0.86)% vs (5.25±0.77)%, P>0.05], but increased in pravastation group [(4.91±0.81)% vs (6.92±0.94)%, P<0.01]. (2)After 6-week pravastation therapy, the levels of platelet CD63?CD62P, plasma PAI-1?ET-1 were obviously improved comparied with those of protreatmeat [(15.48±3.94)% vs (10.12±2.92)%?(14.97±3.24)% vs (10.46±3.45)% ?(11.73±3.18)Au/ml vs (8.12±2.72) Au/ml?(5.97±2.84)ng/L vs (3.28±1.85)ng/L, all P<0.01]. Conclusion The results suggested that cholesterol-lowering therapy with pravastation could improve vascular endothelial function and plasminogen activator ,and had an additional effect on inhibition platelet activatoin in acute coronary syndromes.

关 键 词：冠状动脉疾病 血管内皮 血管舒张功能 危险因子 

分 类 号：R541.4[医药卫生—心血管疾病]