阿托伐他汀对动脉粥样硬化早期血管保护的研究

目的：探讨阿托伐他汀对动脉粥样硬化早期血管保护的作用。方法：选择具有2个以上心血管危险因素而没有动脉粥样硬化斑块的患者120例，随机均分为4组，均予以控制心血管危险因素治疗。其中对照组不使用阿托伐他汀干预，5mg 组、10mg 组、20mg 组予以不同剂量的阿托伐他汀干预。随访6月，观察血栓素 B2（TXB2）、6-酮-前列腺素 F1α（6-Keto-PGF1α）、臂踝脉搏波传导速度（baPWV）、踝臂指数（ABI）以及颈动脉内膜中层厚度（IMT）的变化。结果：4组治疗前后 ABI 和 IMT 无显著变化（P 均＞0.05）。与基线比较，治疗后对照组和5mg组 TXB2、baPWV 水平显著升高，6-Keto-PGF1α水平显著降低；与之相反，10mg 组、20mg 组 TXB2、baPWV 水平显著降低，6-Keto-PGF1α水平显著升高（P ＜0.05～＜0.01）。治疗6个月后与对照组和5mg 组比较，10mg 组、20mg 组的 TXB2（148.3±29.2）pg/ml，，（142.3±30.6）pg/ml 比（111.5±22.8）pg/ml，（104.9±17.4）pg/ml]、baPWV （1621.1±136.1）cm/s，（1597.7±125.3）cm/s 比（1232.9±132.3）cm/s，（1178.2±155.1）cm/s]水平显著降低，6-Keto-PGF1α（104.7±66.1）pg/ml，（102.2±70.3）pg/ml 比（132.8±48.3）pg/ml，（139.1±66.3）pg/ml]水平显著升高（P ＜0.05～＜0.01）。结论：阿托伐他汀对动脉粥样硬化早期血管有保护的作用，10mg 阿托伐他汀可能是血管保护的最低有效剂量。

Protective effect of atorvastatin on blood vessels in early stage of atherosclerosis

Objective：To explore protective effect of atorvastatin on blood vessels in early stage of atherosclerosis （AS）.Methods：A total of 120 patients without AS plaques,who had 〉2 cardiovascular risk factors and received control cardiovascular risk factors therapy,were randomly divided into four groups：control group （did not receive atorvastatin）,atorvastatin 5mg group,10mg group and 20mg group （received corresponding dose of atorvastatin）. All patients were followed up for six months,changes of thromboxane B2 （TXB2）,6-Keto-prostaglandin F1α （6-Keto-PGF1α）,brachial-ankle pulse wave velocity （baPWV）,ankle brachial index （ABI）and intima-media thickness （IMT）were observed.Results：There were no significant changes in ABI and IMT between before and after treat-ment among four groups （P 〉0.05 all）.Compared with baseline,TXB2、baPWV levels significantly rose,6-Keto-PGF1αlevel significantly decreased after treatment in control group and 5mg group;in contrast,TXB2、baPWV lev-els significantly decreased,6-Keto-PGF1αlevel significantly rose after treatment in 10mg group and 20mg group（P 〈0.05~ 〈 0.01）.After treatment six-month,compared with control group and 5mg group,the TXB2 （148.3 ± 29.2）pg/ml,（142.3±30.6）pg/ml vs.（111.5±22.8）pg/ml,（104.9 ± 17.4）pg/ml]、baPWV（1621.1 ± 136.1） cm/s,（1597.7±125.3）cm/s vs.（1232.9±132.3）cm/s,（1178.2±155.1）cm/s]levels significantly decreased,6-Keto-PGF1α（104.7±66.1）pg/ml,（102.2±70.3）pg/ml vs.（132.8±48.3）pg/ml,（139.1±66.3）pg/ml]level significantly rose（P 〈0.05~〈0.01）in 10 mg group and 20 mg group.Conclusion：Atorvastatin has protective effect on blood vessels in early stage of atherosclerosis,and 10mg atorvastatin may be the minimum effective dosage to protect blood vessels.