摘要
目的 探讨他汀类药物对老年颈动脉粥样硬化斑块的影响和对急性心脑血管事件的干预作用及机制.方法 将符合入选标准的180例患者按照抽签方法均分为对照组与观察组,各为90例.对照组采用饮食控制或服用非他汀类降脂药物,观察组在此基础上给予20 mg的辛伐他汀口服,每晚1次,服用12个月.对比两种治疗方法对老年颈动脉粥样硬化斑块的影响,比较两组血脂指标以及急性心脑血管事件的发生率.结果 （1）观察组服药后斑块大小、斑块厚度、斑块数量及内膜中层厚度均比服药前改善,差异有统计学意义（P＜0.05）,且比对照组服药后改善的效果更好,差异有统计学意义（P＜0.05）.（2）观察组服药后血脂指标（总胆固醇、甘油三酯、高密度脂蛋白胆固醇及低密度脂蛋白胆固醇）与血浆超敏C反应蛋白浓度均比服药前改善,差异有统计学意义（P＜0.01）,且比对照组服药后改善的效果更好,差异有统计学意义（P＜0.01）.（3）观察组急性心脑血管事件的发生率要明显低于对照组,差异有统计学意义[1.11％（1/90）vs.8.89％（8/90）,P＜0.01].（4）经Logistic多元回归分析,他汀类药物的预处理（OR=0.36,95％CI：0.21～1.18）、射血分数＜50％ （OR=1.58,95％CI：1.12～2.22）、冠状动脉粥样硬化性心脏病（冠心病）家族史（OR=1.87,95％CI：0.87～2.13）为患者住院期间出现死亡的独立预测因素.结论 持续性服用他汀类药物能够对老年颈动脉粥样硬化斑块起到稳定与消退的作用,且会通过降低血脂使得急性心脑血管事件减少.
Objectives To explore the effect of statins on old age patients with carotid atherosclerotic plaque and its intervention on acute cardiocerebrovascular events.Methods Totally 180 patients according to the selected standard were divided into 2 groups by sortition,90 patients in each group.Patients in control group were adopted alimentary control and took non statins,while patients in observation group were given 20 mg simvastatin per night for 12 months beyond that.The treated effect on carotid atherosclerotic plaque,level blood lipid,acute cardiocerebrovascular events of the two groups were compared.Results （1）The side,thickness,number of plaque and intima-media thickness of observation group after treatment were significantly improved than those of before treatment （P＜0.05）,and the effects were better than those of control group （P＜0.05）.（2）Serum concentrations of total cholesterol,triglyceride,high density lipoprotein cholesferol,low density lipoprotein cholesferol and high sensitivity C reaction protein of observation group after treatment were significantly improved than those of before treatment （P＜0.01）,and the effects were better than those of control group（P＜0.01）.（3）Incidence of acute cardiocerebrovascular events in observation group was obviously lower than that in control group [1.11％ （1/90）vs.8.89％ （8/90）,P＜0.01].（4）Multiple regression analysis indicated that pretreatment with statins （OR=0.36,95％CI：0.21-1.18）,ejection fraction＜50％（OR=1.58,95％CI：1.12-2.22）、atherosclerotic heart disease family history （OR =1.87,95 ％CI：0.87-2.13）were the independent predict factors of patients died in the duration of hospital stay.Conclusions Statins can stabilize and release the carotid atherosclerotic plaque in old age patiens,and reduce the incidence of acute cardiocerebrovascular events by lowering the blood lipid level.
出处
《岭南心血管病杂志》
2014年第1期55-58,共4页
South China Journal of Cardiovascular Diseases
