瑞舒伐他汀强化调脂对不稳定型心绞痛患者血管内皮功能的影响及疗效观察  

Intensive lipid-lowering effect of rosuvastatin on vascular endothelial function in patients with unstable angina pectoris

作　　者：田毅 

机构地区：[1]浙江省文成县人民医院心内科,325300

出　　处：《中国药物与临床》2016年第1期19-21,共3页Chinese Remedies & Clinics

基　　金：温州市科技计划项目(Y20140305)

摘　　要：目的探讨瑞舒伐他汀强化调脂对不稳定型心绞痛(UAP)患者血管内皮功能的影响及疗效观察。方法选取92例UAP患者按随机数字表法分为强化组和普通组各46例。2组均予以阿司匹林、β-受体阻滞剂、硝酸酯类和血管紧张素转换酶抑制剂等基础治疗。普通组在此基础上加用瑞舒伐他汀片10 mg,每天1次,睡前口服,强化组在此基础上加用口服瑞舒伐他汀片20 mg,每天1次,睡前口服,2组疗程均为8周。观察并评估2组患者治疗前后血清内皮素(ET)-1与血管内皮细胞钙黏蛋白(VEC)水平及肱动脉血流介导的内皮依赖性血管舒张功能(FMD)的变化,并比较其临床疗效和药物不良反应。结果强化组和普通组分别发生失访2例与4例,2组的失访率比较差异无统计学意义(P>0.05)。治疗8周后,2组血清ET-1与VEC水平较前明显下降,FMD水平较前明显上升(P<0.05或P<0.01),且强化组变化幅度较普通组更明显(P<0.05)。强化组临床总有效率明显高于普通组(χ2=5.49,P<0.05)。普通组与强化组治疗中分别出现不良反应3例和5例,症状均较轻,2组比较差异无统计学意义(χ2=0.09,P>0.05)。结论瑞舒伐他汀强化调脂治疗UAP患者的疗效较显著,安全性较佳,作用可能与其降低血清ET-1与VEC水平,提高FMD水平,保护与改善血管内皮细胞功能密切相关。Objective To investigate the intensive lipid-lowering effect of Rosuvastatin on vascular endothelial function in patients with unstable angina peetoris （UAP）. Methods Ninety-two UAP patients were included in the study, and randomly divided into the intensive group and the conventional group （n=46 each）. Both groups received basic treatment with aspirin, β-blockers, nitrates and angiotensin converting enzyme inhibitors. The conventional group and the intensive group were additionally given 10 mg and 20 mg oral Rosuvastatin, qd at bedtime, and treated for 8 weeks, respectively. The changes of serum ET-1, VEC levels and FMD before and after the treatment in the two groups were determined and evaluated, and the clinical efficacy and drug adverse reactions were compared as well. Results Two and four cases were lost to follow-up in the intensive group and the conventional group, respectively. There was no statistically significant difference in loss to follow-up rate between the two groups （P〉0.05）. At 8 weeks after the treatment, the serum ET-1 and VEC levels were significantly decreased, and the FMD level was significantly increased compared with those before the treatment in the two groups （P〈0.05 or P〈0.01）. More significant change was found in the intensive group than that in the conventional group （P〈0.05）. The total clinical effective rate in the inten- sive group was significantly higher than that in the conventional group （X2=5.49, P〈0.05）. In the treatment of the con- ventional group and intensive group, there were 3 and 5 cases of adverse reactions with mild symptoms, respectively, and the difference was not statistically significant between the two groups （X2=0.09, P〉0.05）. Conclusion Intensive lipid-lowering effect of rosuvastatin is significant and safe, which may be related to its effects of decreasing serum ET-1 and VEC levels, increasing FMD level, and protecting and improving vascular endothelial function in the treatment of UAP patients.

关 键 词：心绞痛 不稳定型 瑞舒伐他汀 强化调脂 内皮血管 

分 类 号：R541.4[医药卫生—心血管疾病]