阿托伐他汀对cimt和肱动脉内皮依赖性血管舒张-第三军医大学学报.docVIP

阿托伐他汀对CIMT和肱动脉内皮依赖性血管舒张功能的影响 何 坪1 绕学娅1 殷跃辉2 1 重庆医科大学全科医学教育中心　2重庆医科大学附属第二医院心血管内科 [摘要]目的：评价中等剂量阿托伐他汀短期治疗对高血压病者颈动脉内膜中层厚度（CIMＴ）和肱动脉内皮依赖性血管舒张功能的影响。方法：将颈动脉内膜中层厚度（CIMＴ）≥0.8mm的高血压患者分成实验组（n=32人）与对照组（n=30人），实验组口服阿托伐他汀钙（Atorvastation ）20 mg/d，3个月，彩超观察治疗前后变化。结果：治疗后肱动脉血管腔径和流速较治疗前改善57.45%和79.75%（P0.05）,颈总动脉和颈内动脉内膜中层厚度减轻9.18%（P0.05）和8.43%；同时降低血总胆固醇17.73%、LP（a）9.23%、LDL-C21.38%、C-反应蛋白18.68%（P0.05）。增加高血压伴高血脂和CIMT0.9mm的数据，结论：阿托伐他汀钙可能通过降脂、改善血管内皮依赖性舒张功能等作用来延缓或逆转颈动脉粥样硬化程度，对有高血病伴高血脂和CIMT0.9mm者尤为适宜。 关键词： 阿托伐他汀钙，彩色超声，颈动脉内膜中层厚度，血管内皮功能 何 坪 副主任医师 重庆医科大学全科医学教育中心;（400016） 通讯作者：殷跃辉 重庆医科大学附属第二医院（400010） 绕学娅 重庆医科大学公共卫生学院（400016） The effect of Atorvastatin to CIMT and the diastolic function of brachial artery endodermis Heping , ?Yin yuehui , ?Rao xueya , et? al. Department of Cardiology, the second affiliated hospital of Chongqing Medical University. Objective: To evaluate the effect of medium dosage of Atorvastatin in a short-term treatment to hypertensive?patients with? carotid inner membrane stratum medium thickness (CIMT) and the diastolic function of brachial artery endodermis. Method: 62 patients whose CIMT was exceeded 0.8mm were divided into two groups, the experimental group（n=32）and the control group（n=30）.The experimental group were orally given Atorvastation (20 mg/d) ?3 months, then we checked the changes by color Doppler ultrasonograph. Results: the arterial brachialis blood vessel diameter and the flow rate was improved by 57.45% and 79.75%（P0.05）,? the arterial carotis communis and internal carotid artery intima medium thickness was decreased by 9.18% （P0.05）and 8.43%, the total cholesterol was degraded by ?17.73%, LP-a 9.23%, LDL-C 21.38% and C-reactive protein 18.68%（P0.05）.Conclusions: ?Atorvastation can delay or reverse atherosis degree by degrading the fat 、improving the diastolic function of artery endodermis, especially for those who was hyperlipemia or whose CMIT exceeded 0.9mm. KEY WORDS: Atorvastatin Calciu, color Doppler ultrasonograph, medium stratum of caroti