瑞舒伐他汀对冠状动脉侧枝循环形成的影响
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The Effect of Rosuvastatin Therapy on Coronary Collateral Growth
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    摘要:

    目的探讨瑞舒伐他汀对严重冠心病患者冠状动脉侧枝循环形成的影响,及是否具有时间依赖性。方法选取冠状动脉造影结果显示至少1支主要冠状动脉血管狭窄≥95%的冠心病患者395例(男性299例,年龄65±15岁)作为研究对象进行回顾性研究,侧枝的形成按照Rentrop分级系统进行评级,评分0~1分为侧枝循环形成不佳,2~3分为侧枝循环形成良好。记录患者性别、年龄、临床表现、高血压、糖尿病、心肌梗死、冠状动脉搭桥术、吸烟、服用他汀类药物情况及其他药物服用史、血脂水平等,采用SPSS16.0软件及多因素Logistic回归分析等进行统计学分析。结果术前服用瑞舒伐他汀患者有利于侧枝循环形成(P<0.01),根据术前服用瑞舒伐他汀的时间分两组,≤3月组对冠状动脉动脉侧枝循环的形成无明显作用(P0.11),>3月组对侧枝循环的形成有显著意义(P0.003),病变冠状动脉的数量越多(P<0.05)和稳定型心绞痛患者(P<0.01)侧枝循环越好,糖尿病患者侧枝循环形成不良(P<0.05)。结论长期服用瑞舒伐他汀(>3月)、稳定型心绞痛、多支病变与严重冠心病患者冠状动脉侧枝形成密切相关。

    Abstract:

    Aim To investigate the effect of rosuvastatin therapy,including duration of treatment,on coronary collateral growth in patients with advanced coronary artery disease.Methods Study population consisted of 395 (299 men,with the mean age of 65±15 years) consecutive patients who have undergone clinically indicated coronary angiography and had at least one major coronary artery stenosis of ≥95%.Coronary collaterals were graded from 0 to 3 according to the Cohen–Rentrop method and patients with grade 0~1 collateral development were regarded as having poor collateral and patients with grade 2~3 collateral development were regarded as having good collateral.Clinical data including gender,age,clinical manifestation,history of hypertension,diabetes mellitus,myocardial infarction(MI),coronary artery bypass grafting(CABG),somking,statin and other medicines,serum lipid level and so on.SPSS 16.0 and multivariate logistic regression were performed to statistic analysis.Results Patients with good collateral score were on rosuvastatin therapy (P<0.01),and were more likely to have stable angina pectoris as clinical presentation(P<0.01),and have multivessel disease(P<0.05).Rosuvastatin therapy for less than 3 months had no effect on collateral development (P0.11) however,patients who were on statin therapy for more than 3 months had significantly better collateral(P0.003).Diabetes mellitus was the only negative predictor for coronary collateral formation(P<0.05).Conclusion Rosuvastatin therapy (>3 months),stable angina pectoris and having multivessel disease are associated with enhanced coronary collateral development in patients with advanced coronary artery disease.

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侯方杰,邢明青,戴红艳,王晏平,管军.瑞舒伐他汀对冠状动脉侧枝循环形成的影响[J].中国动脉硬化杂志,2014,22(12):1251~1254.

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  • 收稿日期:2014-05-12
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