Jia Xinwei, Wei Meng, Fu Xianghua, Gu Xinshun, Fan Weize, Zhang Jing, Xue Ling
Cardiovascular Department, Second Hospital of Hebei Medical University, Shijiazhuang, P.R. China.
Heart Vessels. 2009 Sep;24(5):340-6. doi: 10.1007/s00380-008-1132-z. Epub 2009 Sep 27.
This study was aimed at probing the effects of intensive cholesterol-lowering therapy with simvastatin on the large artery elasticity of acute myocardial infarction patients. A total of 72 cases of acute myocardial infarction patients were divided into a normocholesterol group (n = 37) and a hypercholesterol group (n = 35) according to their serum low-density lipoprotein. All patients were given oral simvastatin 40 mg/day for 6 months, and their pulse-wave velocity (PWV) of different artery segments and ankle-brachial index (ABI) were measured before and after the therapy. The low-density lipoprotein cholesterol level in both groups decreased significantly (2.13 +/- 0.32 vs 1.56 +/- 0.28, 3.43 +/- 0.80 vs 2.28 +/- 0.47 mmol/l, P < 0.01). The PWV of each artery segment in both the normocholesterol group and the hypercholesterol group decreased significantly (P < 0.05). Pulse-wave velocity in the hypercholesterol group was lowered much more than that of the normocholesterol group (P < 0.05). There were no differences among each artery segment in each group. Ankle-brachial index increased significantly in both groups (1.12 +/- 0.16 to 1.22 +/- 0.12, P < 0.05 in the normocholesterol group, and 1.03 +/- 0.22 to 1.23 +/- 0.16, P < 0.01 in the hypercholesterol group), but ABI increased much more in the hypercholesterol group than in the normocholesterol group (0.21 + 0.15 vs 0.11 + 0.09 P = 0.02). Intensive cholesterol-lowering therapy with simvastatin for acute myocardial infarction patients can significantly improve their large artery elasticity and regress their atherosclerosis. Hypercholesterol patients benefit more from this therapy.
本研究旨在探讨辛伐他汀强化降脂治疗对急性心肌梗死患者大动脉弹性的影响。根据血清低密度脂蛋白水平，将72例急性心肌梗死患者分为正常胆固醇组（n = 37）和高胆固醇组（n = 35）。所有患者均口服辛伐他汀40 mg/天，共6个月，并在治疗前后测量不同动脉节段的脉搏波速度（PWV）和踝臂指数（ABI）。两组患者的低密度脂蛋白胆固醇水平均显著降低（2.13±0.32 vs 1.56±0.28，3.43±0.80 vs 2.28±0.47 mmol/l，P < 0.01）。正常胆固醇组和高胆固醇组各动脉节段的PWV均显著降低（P < 0.05）。高胆固醇组的脉搏波速度下降幅度远大于正常胆固醇组（P < 0.05）。每组各动脉节段之间无差异。两组患者的踝臂指数均显著升高（正常胆固醇组：1.12±0.16至1.22±0.12，P < 0.05；高胆固醇组：1.03±0.22至1.23±0.16，P < 0.01），但高胆固醇组的ABI升高幅度大于正常胆固醇组（0.21 + 0.15 vs 0.11 + 0.09，P = 0.02）。辛伐他汀强化降脂治疗急性心肌梗死患者可显著改善其大动脉弹性并使动脉粥样硬化消退。高胆固醇患者从该治疗中获益更多。
