长期应用瑞舒伐他汀钙对冠心病患者升主动脉弹性功能的影响

摘要

目的 探讨长期应用瑞舒伐他汀钙对冠状动脉粥样硬化性心脏病(冠心病)患者升主动脉弹性功能的影响.方法 选择连云港市第一人民医院于2010年4月~2013年12月住院156例确诊冠心病患者,随机分为观察组(80例)和对照组(76例),两组患者均给予常规冠心病扩冠、抗血小板治疗,观察组应用瑞舒伐他汀钙(10 mg/d)调脂治疗18个月,对照组应用辛伐他汀(20 mg/d)调脂治疗18个月.于治疗前、治疗6个月、12个月和18个月后采用多普勒组织成像技术测定两组患者的升主动脉弹性功能(升主动脉僵硬度指数、升主动脉扩张性、升主动脉前壁S波),并行血清低密度脂蛋白胆固醇(LDL-C)检测,然后进行统计学分析.结果 最终完成试验者142例,观察组(72例)瑞舒伐他汀钙治疗18个月后升主动脉僵硬度指数(2.62±0.39)与治疗前(2.81±0.43)比较明显降低(P=0.012).瑞舒伐他汀钙治疗18个月后升主动脉扩张性(2.11±0.74)×10-4m2/N与治疗前升主动脉扩张性(1.80±0.71)×10-4m2/N比较明显升高(P=0.009),治疗18个月后升主动脉前壁S波速度(0.090±0.010 m/s)与治疗前(0.079±0.014 m/s)比较明显升高(P=0.001).对照组(70例)辛伐他汀治疗后18个月,升主动脉僵硬度指数、扩张性、前壁S波速度与治疗前比较差异均无统计学意义(P均>0.05).观察组治疗18个月后升主动脉僵硬度指数、扩张性、升主动脉前壁S波速度与对照组治疗后18月后比较差异有统计学意义(P均<0.05).结论 瑞舒伐他汀钙长期调脂治疗可显著改善冠心病患者的升主动脉弹性,其调脂治疗效果确切.%Objective To study the effects of using long-term rosuvastatin calcium used on ascending aorta elasticity in patients with coronary atherosclerotic heart disease (CHD).Methods 156 consecutive patients in hospital from 2010 April to 2012 December diagnosed with CHD were divided into rosuvastatin (n=80, rosuvastatin 10 mg, qn) and simvastatin (n=76, simvastatin 20mg, qn) treatment group by random in a 18-month follow-up. Using Doppler tissue imaging assessment, ascending aorta elasticity was evauated by measuring aortic stiffness index, aortic distensibility and S velocity of anterior wall of ascending aorta before treatment and after treatment 6,12 and 18 months, respectively. Serum low density lipoprotein cholesterol (LDL-C), LDL-C was tested. The data described above were statistically analyzed.Results Although no significant difference was observed after 6-month rosuvastatin treatment (72 cases), the aortic stiffness index exhibited significant decrease (P=0.012) until treatment for 18 months compared with the baseline. Both aortic distensibility and S velocity of anterior wall of ascending aorta increased significantly (P<0.05) after 18-month rosuvastatin treatment. After 18 months treatment with simvastatin(70 cases), the aortic stiffness index, the aortic distensibility and S velocity of anterior wall of ascending aorta in patients appeared no significant difference (P>0.05) compared with the baseline group. Conclusion Long-term rosuvastatin calcium treatment in patients with CHD could not only decrease serum LDL-C level, but also be effective in the treatment of the ascending aorta elasticity.