瑞舒伐他汀对冠状动脉血流缓慢的糖尿病患者冠状动脉血流储备的影响

摘要

Objective To investigate the impact of Rosuvastatin on coronary flow reserve in patients with diabetes and coronary slow flow. Methods A total of 61 patients with incipient diabetes (6% 0.05). After Metformin treatment, FBG levels of statin group and non-statin group were significant lower than before(P < 0.05). Baseline CFR levels were significantly lower in statin group and non-statin group than that in control group before Rosuvastatin treated. Compared with non-statin group and statin group before treatment, 6 weeks statin treatment was associated with reduced bCFV, increased hCFV and increased CFR. Conclusion Early statin use on patients with diabetes and CSFP can improve their blood lipid and CFR. This effect is independent of glucose-lowering effect.%目的 探讨瑞舒伐他汀对冠状动脉血流缓慢的糖尿病患者冠状动脉血流储备(CFR)的影响.方法 选择有胸痛症状的初次发现糖尿病患者(6%<糖化血红蛋白<8%)61例,其冠状动脉造影结构正常但伴有冠状动脉血流缓慢现象(CSFP),分为治疗组35例和无治疗组26例.全部糖尿病患者均口服二甲双胍(0.25 g,1 日3 次)6 周,治疗组给予口服瑞舒伐他汀(10 mg,1 日1 次)6 周.另外选择20例冠状动脉造影正常且无CSFP 的无心脏病及糖尿病者为正常对照组.治疗前后测定治疗组及无治疗组的空腹血糖、血脂,并利用腺苷负荷超声记录左前降支远端血流频谱,评价CFR 的改变.结果 口服瑞舒伐他汀6 周后,治疗组总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)明显低于无治疗组及正常对照组(P < 0.05);而高密度脂蛋白胆固醇(HDL-C)高于无治疗组,与正常对照组比较差异无统计学意义(P > 0.05);口服二甲双胍后,治疗组及无治疗组空腹血糖较治疗前明显降低(P < 0.05),与正常对照组比较差异无统计学意义(P > 0.05).给予瑞舒伐他汀治疗前,治疗组及无治疗组CFR 均低于正常对照组(P < 0.05);治疗6 周后,治疗组较治疗前及无治疗组,静息状态下冠状动脉血流速度较低,最大冠状动脉扩张状态下血流速度和CFR 较高(均P < 0.05).结论 伴有CSFP 的糖尿病患者早期应用他汀类药物,在调节血脂的同时,可以改善其CFR,且该作用独立于降糖作用之外.