目的：探讨阿托伐他汀对冠状动脉慢血流（ CSF）患者血脂、血管内皮功能及治疗效果的影响。方法选择2012年5月至2014年9月在延安市人民医院就诊的75例CSF患者为研究对象，采用随机数字表法将患者分为常规治疗组（37例）和阿托伐他汀组（38例）。常规治疗组给予常规治疗：阿司匹林每日100 mg口服、单硝酸异山梨酯每日20 mg口服，合并高血压或糖尿病者给予降脂和降糖治疗，阿托伐他汀组在常规治疗组的基础上给予阿托伐他汀每日10 mg口服治疗。两组患者均治疗4周。比较两组患者的血脂水平、内皮功能以及疗效。结果治疗后，阿托伐他汀组患者三酰甘油、总胆固醇、低密度脂蛋白胆固醇、载脂蛋白B水平明显低于常规治疗组[（2.3±0.4） mmol／L比（3.3±0.5） mmol／L、（4.0±0.5） mmol／L 比（4.9±0.6） mmol／L、（1.78±0.18） mmol／L 比（2.38±0.29） mmol／L、（0.89±0.08） g／L 比（1.22±0.18） g／L]，高密度脂蛋白胆固醇、载脂蛋白AⅠ水平明显高于常规治疗组[（1.89±0.22） mmol／L 比（1.33±0.16） mmol／L，（1.55±0.22） g／L比（1.23±0.14） g／L]（P＜0.05）；阿托伐他汀组患者左前降支、左回旋支、右冠状动脉的心肌梗死溶栓试验帧数均明显少于常规治疗组[（34.0±4.2）比（42.6±4.4）、（36.1±4.4）比（45.7±4.7）、（33.5±3.7）比（40.1±4.2）]（P＜0.01）；阿托伐他汀组患者血浆内皮素1的水平明显低于常规治疗组[（68.1±7.3） ng／L 比（105.3±12.5） ng／L]，一氧化氮水平明显高于常规治疗组[（56.8±6.7）μmol／L比（41.5±4.6）μmol／L]，差异均有统计学意义（P＜0.01）。结论阿托伐他汀能够改善血脂代谢，加快血流速度，保护内皮功能，是治疗CSF的理想药物。%Objective To study the effect of atorvastatin on blood fat and vascular endothelium function of patients with coronary slow flow(CSF).Methods Total of 75 patients with CSF in Yan′an People′s Hos-pital from May 2012 to Sep.2014 were included in the study and divided into a conventional therapy group (37 cases) and an atorvastatin group (38 cases) according to random number table method.The convention-al therapy group was given conventional treatment,aspirin daily 100 mg per oral,20 mg oral administration of isosorbide mononitrate,patients complicated with hypertension or diabetes were given blood lipid and hypo-glycemic treatment.On the basis of the conventional therapy group′s regimen,the atorvastatin group was given atorvastatin 10 mg daily per oral.Both of the groups were treated for 4 weeks, and blood lipid levels,endothe-lial function and efficacy of the two groups were compared before and after treatment .Results After treat-ment,the triacylglycerol,total cholesterol,low density lipoprotein cholesterol and apolipoprotein B levels of the atorvastatin group were significantly lower than the conventional therapy group[(2.3 ±0.4) mmol/L vs (3.3 ±0.5) mmol/L,(4.0 ±0.5) mmol/L vs (4.9 ±0.6) mmol/L,(1.78 ±0.18) mmol/L vs (2.38 ± 0.29) mmol/L,(0.89 ±0.08) g/L vs (1.22 ±0.18) g/L];the levels of high density lipoprotein choles-terol and apolipoprotein AⅠ were significantly higher than the conventional therapy group [ ( 1.89 ± 0.22) mmol/L vs (1.33 ±0.16) mmol/L,(1.55 ±0.22) g/L vs (1.23 ±0.14) g/L](P<0.05);TIMI frames of left anterior descending artery,left circumflex and right coronary artery in the atorvastatin group were significantly less than the conventional therapy group [ ( 34.0 ±4.2 ) vs ( 42.6 ±4.4 ) , ( 36.1 ± 4.4) vs (45.7 ±4.7),(33.5 ±3.7) vs (40.1 ±4.2)] (P<0.01);the plasma endothelin-1 of the con-ventional therapy group was lower than the atorvastatin group[(68.1 ±7.3) ng/L vs (105.3 ±12.5) ng/L], NO was higher than the atorvastatin group[(56.8 ±6.7) μmol/L vs (41.5 ±4.6) μmol/L],the differ-ences had statistical significance(P<0.01).Conclusion Atorvastatin can improve lipid metabolism,accel-erate blood flow velocity,and protect endothelial function,thus is an ideal drug therapy for CSF.
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