普伐他汀对不稳定型心绞痛患者血管内皮功能的影响

摘要

目的 探讨普伐他汀对不稳定型心绞痛患者血管内皮功能的影响.方法 选择2011年3月至2013年3月浙江省丽水市中医医院收治的100例不稳定型心绞痛患者,根据随机数字表法将其分为普伐他汀组与常规治疗组,每组50例.普伐他汀组患者给予常规硝酸异山梨醇酯、肠溶阿司匹林片、β受体阻滞剂、硝酸甘油和肝素钠进行治疗;普伐他汀组在常规治疗组的基础上加用普伐他汀片20 mg,每晚睡前口服.治疗前及治疗6周后对2组患者的总胆固醇、三酰甘油、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血浆内皮素1、一氧化氮、丙二醛等水平进行比较与分析.结果 治疗后普伐他汀组的总胆固醇、三酰甘油和LDL-C水平明显低于常规治疗组,差异均有统计学意义[(4.9±0.3)mmol/L比(5.3-0.5) mmol/L,(1.2±0.2) mmol/L比(1.6 ±0.4) mmol/L,(3.1±0.3)mmol/L比(3.5±0.5) mmol/L,P＜0.05],而HDL-C水平明显高于常规治疗组,差异亦有统计学意义[(1.6±0.4) mmol/L比(1.4±0.2)mmol/L,t=4.743,P＜0.05];治疗后普伐他汀组的内皮素1与丙二醛水平明显低于常规治疗组,差异有统计学意义[(51±13)ng/L比(61±14) ng/L,(6.0±1.7) μmol/L比(6.8±1.9) μmol/L,t=3.462、2.219,P＜0.05],而一氧化氮水平明显高于常规治疗组,差异有统计学意义[(63±15) μmol/L比(55±13) μmol/L,t =2.871,P＜0.05].结论 普伐他汀联合常规疗法治疗不稳定型心绞痛可有效改善血管内皮功能,降低血脂,稳定血压.%Objective To investigate and analyze the effect of pravastatin on vascular endothelial function in unstable angina patients.Methods All 100 patients with unstable angina received in our hospital from March 2011 to Mar 2013 were divided into parvastatin group and routine group according to a random number table,with 50 cases in each group.The patients in routine group were given conventional isosorbide dinitrate,enteric-coated aspirin tablets,β-blockers,nitroglycerin and heparin for treatment; the parvastatin group was given pravastatin tablets on the base of routine group.The total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),endothelin,nitric oxide,and malondialdehyde levels in the two groups of patients before treatment and after six weeks treatment were compared and analyzed.Results TC,TG and LDL-C levels in parvastatin group after treatment were significantly lower than the routine group,the differences were statistically significant (t =4.851,6.325,4.851,P ＜ 0.05),while HDL-C levels were significantly higher than routine group,there was statistically significant difference (t =4.743,P ＜ 0.05) ;endothelin and malondialdehyde levels in parvastatin group after treatment was significantly lower than the routine group,the differences were statistically significant (t =3.462,2.219,P ＜ 0.05),and the nitric oxide levels were significantly higher the routine group,the differences were statistically significant (t =2.871,P ＜ 0.05).Conclusion Pravastatin combined conventional therapy for unstable angina pectoris can effectively improve endothelial function,lower blood lipids and stabilize blood pressure.