阿托伐他汀对高胆固醇血症患者脉搏波传导速度和臂踝指数的影响

摘要

Objective To investigate the short-term influences of atorvastatin on brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) in patients with hypercholesterolemia (TC≥5.7 mmol/L and/or LDL-C≥3.6 mmol/L). Methods The patients (n=78) were chosen from the Fourth Affiliated Hospital of Kunming Medical University from May 2011 to Nov. 2011, and then divided randomly into two groups. Control group (n=39) was given diet control only and treatment group (n=39) was given atorvastatin (20 mg/d). The changes of baPWV and ABI were observed and compared between two group before and 6 months after treatment. Results The level of blood fat decreased in two groups after treatment, which was more significant in treatment group (P<0.05). In control group, baPWV and ABI had no changes after treatment [baPWV:(1539±171.9) m/s vs. (1527±232.2) m/s;ABI:(1.2±0.2) vs. (1.2±0.3)], and in treatment group, baPWV decreased [(1442±102.1) m/s vs. (1580±205.2) m/s, P<0.05] and ABI increased [(1.3±0.3) vs. (1.2±0.3), P<0.05], which were improved compared with control group after treatment. Conclusion Atorvastatin can improve baPWV and ABI and relieve peripheral vascular sclerosis in the patients with hypercholesterolemia.%目的：探讨阿托伐他汀对高胆固醇血症患者[血浆胆固醇（TC）≥5.7 mmol/L和（或）低密度脂蛋白（LDL-C）≥3.6 mmol/L]臂踝脉搏波传导速度（baPWV）和踝臂指数（ABI）的短期影响。方法纳入2011年5月~2011年11月昆明医科大学第四附属医院高胆固醇血症患者78例，所有患者签署知情同意书后随机分为两组，对照组仅给予饮食控制（n=39），治疗组加用阿托伐他汀20mg（n=39）。观察两组患者血脂水平的变化，采用无创性动脉硬化检测方法，观察治疗6个月前后两组患者baPWV和ABI的变化及治疗后两组之间差异。结果与治疗前相比，治疗后两组血脂均下降，处理组下降更为明显，差异有统计学意义（P＜0.05）；对照组治疗后baPWV和ABI较治疗前无变化[baPWV：（1539±171.9）m/s vs.（1527±232.2）m/s；ABI：（1.2±0.2）vs.（1.2±0.3）]，治疗组baPWV较治疗前下降[（1442±102.1） m/s vs.（1580±205.2）m/s]，差异有统计学意义（P＜0.05），ABI较治疗前升高[（1.3±0.3） vs.（1.2±0.3）]，差异有统计学意义（P＜0.05），与对照组治疗后相比亦有改善。结论阿托伐他汀可改善高胆固醇血症患者baPWV、ABI值，对外周动脉硬化有改善作用。