辛伐他汀治疗无症状性颈动脉粥样硬化的疗效观察

Observation on Efficacy of Pharmaceutical Treatment of Non-symptomatic Carotid Atherosclerosis With Simvastatin

目的采用颈动脉超声观察辛伐他汀治疗无症状性颈动脉粥样硬化的疗效。方法对参加我院健康体检时经彩超检查发现有颈动脉斑块的观察病例68例,每晚服用辛伐他汀,连续4月,观察颈动脉斑块的面积变化以及血脂的动态改变。结果68例观察者共发现斑块112个,服药4月后发现低回声斑块面积消退幅度达32%,混合性斑块达25%,高回声斑块只有9%,平均消退幅度22%,除高回声斑块外,其他均有明显统计学意义(P<0.05)。患者的TC下降与治疗前比较有显著差异(P<0.01),TG、LDL的下降与治疗前比较有明显差异(P<0.05),HDL有所升高,但无统计学意义。结论通过观察服用辛伐他汀4月后斑块的面积变化以及血脂的改变结果表明,坚持服用他汀类药物,可以达到稳定与消退斑块的作用。

Objective To observe the efficacy of pharmaceutical treatment of non symptomatic carotid atherosclerosis plaques with simvastatin. Methods Uniform ultrasonic scanning was implemented to obtain plaque area and number in 68 patients with carotid atherosclerosis. All the patients received simvastatin 20mg at bedtime for successive 4 months, ultrasonographic imaging was used to quantify plaque area again and HDL, LDL, TC, TG, ALT, BUN, Cr and CK were monitored. Results There were 112 plaques among these 68 patients. After a 4 month simvastatin treatment, low density plaque area decreased by 32 %, equal- density plaque area decreased by 25 %, and high- density plaque area decreased by 9 %, the plaque level decreased by 22 % except the high density plaques, the area of carotid atherosclerosis plaque reduced significantly （P〈 0.0.5）. TC, TG, and LDL reduced significantly （P〈 0.01, 0.0.5, 0.0.5）, HDL had a little increase, but did not reach statistical significant level. Conclusion The results demonstrate that simvastatin treatment is associated with a significant regression and stabilization of carotid atherosclerotic plaques and reduction of cholesterol level.