摘要
目的:研究在肥胖高胆固醇血症患者中应用不同剂量阿托伐他汀及停服后对血管内皮功能和炎症因子的影响,探讨其可能的机制。方法:观察入选的55名肥胖高胆固醇血症患者和58名健康者肱动脉内皮依赖性舒张功能,并检测血清中NO,可溶性E-选择素(SE)及高敏C反应蛋白(hs-CRP)含量的变化。将55名肥胖高胆固醇血症患者随机双盲分成两组:A组27例,在常规饮食控制基础上予阿托伐他汀10 mg/d;B组28例,在常规饮食控制基础上予阿托伐他汀20 mg/d。8周1疗程,观察两组治疗前、治疗后及停药1周后上述指标及血脂的变化。结果:阿托伐他汀治疗8周后可明显降低肥胖高胆固醇血症患者总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、SE和hs-CRP水平(均P<0.01),明显提高NO水平(P<0.01),改善肱动脉内皮依赖性舒张功能(P<0.05或P<0.01);其中B组较A组上述改变更显著(P<0.05)。停药1周后两组TC和LDL-C水平均较治疗8周时明显升高(P<0.05),但仍低于治疗前水平(P<0.05或P<0.01);两组NO和肱动脉内皮依赖性舒张功能均明显下降,恢复至治疗前水平(P>0.05),两组SE和hs-CRP均明显升高,也恢复至治疗前水平(P>0.05)。结论:对肥胖高胆固醇血症患者应用阿托伐他汀20 mg/d较10 mg/d更能有效控制血脂水平,改善内皮功能和抑制炎症反应。而突然终止阿托伐他汀治疗可在1周内完全逆转该药对血管内皮功能的改善作用和炎症反应的抑制作用,停药对血管内皮功能和炎症因子的影响是非胆固醇依赖性作用。
Objective To determine the effect of different doses of atorvastatin and withdrawal of atorvastatin on vascular endothelial function and inflammation factors in the patients with hypercholestero-lemia and obesity and to explore the possible mechanism.Methods Fifty-five patients with hypercholes-terolemia and obesity and 58 healthy controls were recruited to observe brachial artery endothelial-dependent vasodilation,serum concentration of NO,soluble E-selectin（SE）,and high sensitive C-reactive protein（hs-CRP）.The 55 patients were randomly,double-blindly divided into 2 groups：Group A（n=27）,received atorvastatin 10 mg per day,and Group B（n=28）,received atorvatatin 10 mg per day for 8 weeks at the base of diet control.Endothelial dependent flow-mediated vasodilation（FMD）,NO,SE,hs-CRP,and blood lipid were evaluated before the treatment,after 8 weeks of atorvastatin treatment,and 1 week of therapy termination.Results Atorvastatin treatment for 8 weeks reduced total cholesterol（TC）,low density lipoprotein cholesterol（LDL-C）,SE,and hs-CRP,and improved NO and FMD obviously in patients（P〈0.01）.Comparing with the Group A,the above-mentioned changes in the Group B were more profound.Withdrawal of atorvastatin for a week,TC and LDL-C levels were significantly increased compared with those after 8 weeks treatment（P〈0.05）,but still lower than those before treatment（P〈0.05 or P〈0.01） in the two groups.The levels of NO and FMD decreased whereas the SE and hs-CRP levels were elevated than those after 8 weeks treatment（P〈0.01）,and there was no obvious changes compared with those before the treatment（P〈0.05）.Conclusion Atorvastatin 20 mg per day reduces TC,LDL-C,protects endothelial function,and inhibits inflammation to a greater extent than 10 mg per day.Sudden withdrawal of atorvastatin therapy,the beneficial effects on endothelial function and inflammation inhibition were attenuated.Effects of therapy termination on vascular endothelial function and inflammation factor
出处
《国际病理科学与临床杂志》
CAS
2010年第1期8-13,共6页
Journal of International Pathology and Clinical Medicine
基金
湖南省卫生厅课题(B2007-030)~~
关键词
阿托伐他汀
肥胖
高脂血症
血管内皮功能
炎症因子
atorvastatin
obesity
hypercholesterolemia
vascular endothelial function
inflammation factor
