长期小剂量阿托伐他汀联合非诺贝特对颈动脉粥样硬化的影响

Effect of Long-term Low Dose Atorvastatin Combined with Fenofibrate on Lipid Regulation and Carotid Atherosclerosis

目的:观察小剂量阿托伐他汀联合非诺贝特对冠心病、冠心病等危征、代谢综合征等患者颈动脉粥样硬化内中膜厚度(IMT)及血脂成分的影响。方法:冠心病、冠心病等危征及代谢综合征患者82例,随机分为联合用药组及对照组,对照组单纯给与阿伐托拉丁治疗,联合用药组加用非若贝特治疗,共12月;彩色超声检查两组患者治疗前后颈动脉IMT、斑块数量及斑块稳定性,对IMT值与总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)及脂蛋白a(apo-A)进行相关性分析。结果:治疗后联合用药组IMT减小,斑块数量及不稳定斑块数量减少(P<0.05),对照组3项指标与治疗前比较无显著变化(P>0.05);相关性分析结果显示,IMT与血清中TC、TG、LDL及apo-A正相关,与HDL负相关。结论:长期小剂量阿托伐他汀联合非诺贝特治疗冠心病、冠心病危象及代谢综合征患者可以减缓颈动脉粥样硬化病变进程。

Objective:To examine the effects of low-dose atorvastatin combined with fenofibrate on intima-media thickness(IMT)of carotid atherosclerosis and lipid composition in patients with coronary heart disease(CHD),or CHD risk equivalents or other metabolic syndromes.Methods:82 patients with CHD,or CHD risk equivalents,or other metabolic syndromes were randomly divided into the combination group and the control group.The control group was given 10 mg apratolide alone,and the combination group was treated with 10 mg apratolide plus 200 mg fenofibrate.The treatment lasted 12 months.Color ultrasound was used to examine carotid IMT,plaque number and plaque stability before and after treatment.The correlation of IMT value with total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL-C),low-density lipoprotein(LDL-C)and lipoprotein a(apo-A)were analyzed.Results:The combination treatment significantly decreased the IMT values,the number of plaques and the number of unstable plaques(P<0.05),but apratolide alone did not significantly influence these three indexes in control group(P>0.05).The correlation analysis showed that IMT is positively correlated with serum TC,TG,LDL and apo-A,but negatively correlated with HDL.Conclusion:Long-term low-dose atorvastatin combined with fenofibrate can reduce the progression of carotid atherosclerosis in patients with CHD,or CHD risk equivalents,or other metabolic syndrome.