Weverling-Rijnsburger A W E, Blauw G J, Meinders A E
Department of General Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands.
J Clin Pharm Ther. 2004 Apr;29(2):157-64. doi: 10.1111/j.1365-2710.2004.00548.x.
This study was initiated to examine the effect of cholesterol-lowering therapy with 40 mg atorvastatin on vascular function in healthy old and young men.
We selected healthy normolipidaemic, elderly subjects (n = 8, mean age 80.1 years) and young subjects (n = 7, mean age 21.8 years). All had a normal electrocardiograph and blood pressure, and signs or symptoms of cardiovascular disease were absent. The subjects were studied for 2 days, with 6 weeks of atorvastatin treatment in between. Forearm blood flow (FBF) was measured by computerized venous occlusion plethysmography upon intra-arterial infusion of acetylcholine (ACh; 30 and 90 ng/kg/min) and 5-hydroxytryptamine (5-HT; 0.3 and 0.9 ng/kg/min) as endothelium-dependent vasodilators, and sodium nitroprusside (SNP; 30 and 90 ng/kg/min) as an endothelium-independent vasodilator.
At baseline, the mean absolute FBF in the elderly was 2.6 mL/min/100 mL and in the young 4.3 mL/min/100 mL tissue (P = 0.01). The mean serum total cholesterol levels were 5.2 and 3.8 mmol/L, respectively (P = 0.007). The endothelium-dependent vasodilatation induced by ACh and 5-HT was significantly lower in the elderly compared with the young (both P < 0.01), whereas the endothelium-independent vasodilatation induced by SNP was not significantly lower in the elderly compared with the young. Atorvastatin treatment decreased the serum total cholesterol level with a mean of 38 and 28% in the elderly and the young, respectively (P < 0.001). Impaired endothelium-dependent vasodilatation, however, was not modified (P > 0.65).
Healthy old men have an impaired endothelium-dependent vascular response but this impairment is not restored by treatment with atorvastatin.
开展本研究以检测40毫克阿托伐他汀的降胆固醇治疗对健康老年男性和青年男性血管功能的影响。
我们选取了健康的血脂正常的老年受试者（n = 8，平均年龄80.1岁）和青年受试者（n = 7，平均年龄21.8岁）。所有人的心电图和血压均正常，且无心血管疾病的体征或症状。对受试者进行为期2天的研究，中间间隔6周的阿托伐他汀治疗。通过计算机化静脉阻塞体积描记法测量前臂血流量（FBF），动脉内输注乙酰胆碱（ACh；30和90纳克/千克/分钟）和5-羟色胺（5-HT；0.3和0.9纳克/千克/分钟）作为内皮依赖性血管舒张剂，输注硝普钠（SNP；30和90纳克/千克/分钟）作为非内皮依赖性血管舒张剂。
在基线时，老年组的平均绝对FBF为2.6毫升/分钟/100毫升组织，青年组为4.3毫升/分钟/100毫升组织（P = 0.01）。平均血清总胆固醇水平分别为5.2和3.8毫摩尔/升（P = 0.007）。与青年组相比，老年组中由ACh和5-HT诱导的内皮依赖性血管舒张明显更低（均P < 0.01），而与青年组相比，老年组中由SNP诱导的非内皮依赖性血管舒张并无明显更低。阿托伐他汀治疗使老年组和青年组的血清总胆固醇水平分别平均降低了38%和28%（P < 0.001）。然而，受损的内皮依赖性血管舒张并未得到改善（P > 0.65）。
健康老年男性存在内皮依赖性血管反应受损的情况，但阿托伐他汀治疗无法恢复这种损伤。
