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目的 :研究普伐他汀对老年陈旧性心肌梗死 (OMI)患者血管内皮的作用并初步探讨其可能机制。方法 :将 6 0例老年OMI患者随机均分为安慰剂 (C)组和普伐他汀 (P)组 ,分别测定血脂 [总胆固醇 (TC)、三酰甘油 (TG)、低密度脂蛋白胆固醇 (LDL C)、高密度脂蛋白胆固醇 (HDL C) ]、血浆内皮素 (ET)及一氧化氮 (NO)浓度变化 ,血小板表面α颗粒膜蛋白 (GMP 14 0 )表达及内皮依赖性扩张百分率 (FMD % )和非内皮依赖性扩张百分率(GTN % )。结果 :P组经普伐他汀治疗 6周后 ,TC含量较治疗前下降 2 9% ,LDL C下降 35 % ,HDL C升高 8% ,但TG水平无明显变化 ,内皮功能得到了明显的改善 ,GMP 14 0表达受到抑制 ,而这种表达抑制与血胆固醇水平的改变无关。结论 :普伐他汀能通过调脂及抑制血小板的活性参与血管内皮功能的改善 ,在老年OMI患者中应用普伐他汀可能通过改善内皮功能达到降低心脑血管事件发生的目的
Objective: To investigate the effect of pravastatin on the vascular endothelium in aged patients with old myocardial infarction (OMI) and to explore its possible mechanism. Methods: Sixty elderly OMI patients were randomly divided into placebo group (C) and pravastatin group (P). The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL C, HDL C), plasma endothelin (ET) and nitric oxide (NO), the expression of GMP 14 0 and the percentage of endothelium-dependent dilatation (FMD%) and non-endothelium-dependent dilatation (GTN%). Results: In the P group, after 6 weeks of pravastatin treatment, the TC content decreased by 29%, the LDL C decreased by 35% and the HDL C increased by 8%, but the TG level did not change significantly and the endothelial function was significantly improved , GMP14 0 expression is inhibited, and this expression inhibition has nothing to do with the change of blood cholesterol level. Conclusion: Pravastatin can participate in the improvement of vascular endothelial function through lipid-lowering and inhibiting platelet activity. The application of pravastatin in elderly OMI patients may achieve the purpose of reducing cardiovascular and cerebrovascular events by improving endothelial function