Schobel H P, Schmieder R E
Department of Internal Medicine IV, University of Erlangen-Nürnberg, Germany.
Angiology. 1998 Sep;49(9):743-8. doi: 10.1177/000331979804901006.
Atherosclerotic vessels are characterized by endothelial and structural abnormalities as indicated by an impaired vasodilation to metabolic requirements. To determine whether effective treatment of hypercholesterolemia may improve vasodilatory capacity of resistance vessels, the authors examined the impact of 12 and 24 weeks of lipid-lowering therapy with the hepatic hydroxymethylglutaryl coenzyme A (HMG-CoA)-reductase inhibitor fluvastatin (40 to 80 mg/day) on the increment in forearm blood flow during reactive hyperemia in 24 hypercholesterolemic patients (mean age: 56 +/- 11 years; 15 men/9 women). Changes in forearm blood flow in response to reactive hyperemia were measured by venous occlusion plethysmography. Serum low-density lipoprotein (LDL)-cholesterol fell from 213 +/- 32 to 125 +/- 27 mg/dL (P<0.001) after 12 weeks and remained stable at a level of 125 +/- 18 mg/dL after 24 weeks of treatment. Baseline forearm blood flow was similar before and after 12 and 24 weeks of therapy. In contrast, forearm blood flow at peak reactive hyperemia was greater at week 12 (37.0 +/- 22.9 mL/min/100 mL; P<0.05), and at week 24 (47.1 +/- 33.5 mL/min/100 mL; P<0.05) than at week 0 (30.5 +/- 18.1 mL/min/100 mL). Compared with week 0 (defined as 100%), the percent change in forearm blood flow in response to reactive hyperemia was augmented at week 12 (171 +/- 144%; P<0.05 vs week 0) and at week 24 (218 +/- 228%; P<0.05 vs week 0). Thus, the lowering of high serum LDL cholesterol after short-term treatment with fluvastatin increased the blood flow responses during reactive hyperemia in forearm resistance vessels. These data indicate a beneficial effect of HMG-CoA reductase inhibition on structural wall properties of peripheral arteries in human atherosclerosis.
动脉粥样硬化血管的特征是内皮和结构异常，表现为血管舒张功能无法满足代谢需求。为了确定有效治疗高胆固醇血症是否可以改善阻力血管的舒张能力，作者研究了使用肝羟甲基戊二酰辅酶A（HMG-CoA）还原酶抑制剂氟伐他汀（40至80毫克/天）进行12周和24周降脂治疗对24例高胆固醇血症患者（平均年龄：56±11岁；15名男性/9名女性）反应性充血期间前臂血流量增加的影响。通过静脉阻塞体积描记法测量反应性充血引起的前臂血流量变化。治疗12周后，血清低密度脂蛋白（LDL）胆固醇从213±32降至125±27毫克/分升（P<0.001），治疗24周后稳定在125±18毫克/分升水平。治疗12周和24周前后的基线前臂血流量相似。相比之下，反应性充血峰值时的前臂血流量在第12周（37.0±22.9毫升/分钟/100毫升；P<0.05）和第24周（47.1±33.5毫升/分钟/100毫升；P<0.05）高于第0周（30.5±18.1毫升/分钟/100毫升）。与第0周（定义为100%）相比，反应性充血引起的前臂血流量变化百分比在第1周（171±144%；与第0周相比P<0.05）和第24周（218±228%；与第0周相比P<0.05）增加。因此，短期使用氟伐他汀降低高血清LDL胆固醇可增加前臂阻力血管反应性充血期间的血流反应。这些数据表明HMG-CoA还原酶抑制对人类动脉粥样硬化外周动脉的结构壁特性具有有益作用。
