摘要
目的 探讨洛伐他汀治疗冠心病高胆固醇血症患者 ,对血管内皮功能、微循环及胰岛素敏感性 (IS)的影响。方法 4 5例冠心病高胆固醇血症患者 (治疗组 )给予洛伐他汀 (血脂康 )治疗 ,测定治疗前和治疗后 4、8周以及 4 0例正常对照者血脂谱、空腹血糖 (FPG)、空腹胰岛素 (FINS)、一氧化氮 (NO)、内皮素 (ET)、6 -酮 -前列腺素 (6 -Keto -PGF1α)、血栓素B2 (TXB2 )以及甲襞微循环 (NFM )检测并计算总积分值 ,计算IS指数。结果 与对照组比较 ,治疗组治疗前ET、TXB2 、NFM总积分值显著升高 ,NO、6 -Keto -PGF1α、IS指数显著降低。治疗后 4周较治疗前ET、TXB2 、NFM总积分值显著下降 5 3 16± 15 2 3和 6 3 19± 18 72 (P <0 0 1) ,84 13± 2 2 6 7和 94 81± 2 4 6 6 (P <0 0 5 ) ,3 75± 1 0 2和 4 4 6± 1 84 (P <0 0 5 ) ;6 -Keto -PGF1α、NO、IS指数明显升高6 6 89± 18 0 4和 5 4 32± 2 1 73(P <0 0 1) ,5 89± 1 5 4和 5 13± 1 38(P <0 0 5 ) ,- 4 37± 0 34(0 5 2 )和 -4 5 9± 0 4 7(0 4 2 ) (P <0 0 5 ) ;治疗后 8周与治疗前比较TXB2 、NFM总积分值进一步下降P值均 <0 0 1。NO、IS指数进一步升高P值均 <0 0 1,且IS指数的升高与NFM总积分值的下降呈显著负相关关系r =-
Objective To study the effects of lovastatin in the therapy of primary hypercholesterolemia on insulin sensitivity,vascular endothelial function and microcirculation in patients with coronary heart disease.Methods Forty-five patients,diagnosed as coronary heart disease and primary hypercholesterolemia,were treated by lovastatin for 8 weeks.Serum lipids,fasting plasma glucose (FPG),fasting insulin(FINS),nitric oxide(NO),endothelin(ET),6-keto-prostacyclin F 1α(6-keto-PGF 1α),thromboxane B 2(TXB 2) and nail-fold microcirculation (NFM) were measured and the score value of NFM and insulin sensitivity(IS) index were calculated in treatment group before and after 4-week and 8-week treatment with lovastatin.Forty healthy persons were taken as control.Results In treatment group,ET,TXB 2,and the score value of NFM were higher and NO,6-keto-PGF 1α and IS index were lower than those in control group.After 4-week lovastatin treatment,compared with baseline value,ET,TXB 2,and the score value of NFM significantly decreased,which were 63.19±18.72 vs 53.16±15.23 (P<0.01),94.81±24.66 vs 84.13±22.67 (P<0.05),4.46±1.84 vs 3.75±1.02 (P<0.05);while 6-keto-PGF 1α,NO and IS index significantly increased,which were 54.32±21.73 vs 66.89±18.04 (P<0.01),5.13±1.38 vs 5.89±1.54 (P<0.05),-4.59±0.47(0.42) vs -4.37±0.34(0.52)(P<0.05),respectively.After 8-week treatment,TXB 2 and the score value of NFM decreased significantly (both P<0.01),but NO and IS index increased significantly (both P<0.01).The increase of IS index was correlated with the decrease of the score value of NFM (r=-0.71,P<0.05).Conclusion Lovastatin can lower serum lipid level,improve vascular endothelial function and microcirculation and reduce insulin resistance.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2003年第11期660-662,共3页
Chinese Journal of Practical Internal Medicine
