摘要
目的观察20mg/d阿托伐他汀钙对无症状性颈动脉斑块患者血脂及斑块的影响。方法选取2006年1月至12月河北医科大学第一医院神经内科门诊及查体中心,经颈动脉彩色超声证实有颈动脉斑块,自愿参加临床观察的131例患者作为观察对象,随机分为阿托伐他汀钙治疗组(简称治疗组)63例及对照组68例。分别于治疗前、治疗后3、6、12、18、24个月测定两组血脂及颈动脉斑块情况,并观察终点事件及不良反应情况。结果治疗组与对照组脱落率及终点事件发生率差异无统计学意义。治疗组3个月起血胆固醇、低密度脂蛋白、甘油三酯明显降低,6个月起高密度脂蛋白明显升高,与治疗前比较差异有统计学意义(P值分别为0.009,<0.01,0.004,0.025)。对照组血脂各项指标在24个月观察期内差异均无统计学意义(P值分别为0.701,0.512,0.892,0.901)。治疗组斑块面积从治疗12个月起,较治疗前明显减小,稳定斑块逐渐增多,不稳定斑块逐渐减少,至治疗18个月起与治疗前比较差异有统计学意义(P值分别为0.022,0.002,0.007)。对照组颈动脉斑块总数、稳定斑块、不稳定斑块及斑块面积有逐渐增多的趋势,但与治疗前比较差异无统计学意义(P值分别为0.274,0.830,0.595,0.356)。治疗组无严重副反应发生。结论 20mg/d阿托伐他汀钙治疗能够显著改善无症状性颈动脉斑块患者血脂及颈动脉硬化的程度。
Objective To observe the effect of 20 mg/d of atorvastatin on lipids levels and plaque in asymptomatic patients with carotid artery plaque. Methods One hundred and thirty-one patients were included in this study in 2006 ,who were confirmed as carotid artery plaque with color Doppler ultrasound in the First Hospital of Hebei Medical University. Those patients were divided into atorvastatin calcium treatment group （ treatment group, 63 cases） and control group（68 cases）. Blood lipids and carotid artery plaque in two groups were assayed before treatment and 3,6,12,18,24 months after treatment. Meanwhile, primary end point and adverse reaction were recorded. Results There was no significant difference in falling rate and the primary end point in two groups. The blood cholesterol,low-density lipoprotein and triglyceride levels were significantly lower in 3 months and high-den- sity lipoprotein significantly increased in 6 months after atorvastatin treatment compared with those before treatment（P =0. 009, 〈0. 01,0. 004,0. 025）. There was no significant difference in blood lipids in the control group in 24 months（P =0. 701,0. 512,0. 892,0. 901 ）. Plaque area was reduced significantly in the treatment group 12 months after atorvastatin treatment and showed progressive reduction （ P = 0. 022 ）. Meanlwhile, unstable plaques were reduced and stable plaques were increased gradually（ P =0. 002,0. 007 ）. The total number of carotid artery plaques, stable plaques, unstable plaques and plaque area were increased gradually in the control group in 24 months, but there was no significant difference compared with those before treatment （P = 0. 701,0. 512,0. 892, 0. 901 ）. Conclusion Atorvastatin can significantly decrease blood lipids and carotid artery plaques, especially unstable plaques. It may be an proper choice using atorvastatin （20mg/d） for the Chinese.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2010年第6期521-524,共4页
Chinese Journal of Practical Internal Medicine
基金
河北省重大科技攻关计划(06276105D)
关键词
阿托伐他汀钙
颈动脉斑块
血脂
颈动脉彩色超声
atorvastatin
carotid artery plaque
lipids
carotid artery color doppler ultrasound
