长期应用阿托伐他汀对冠心病患者颈动脉粥样斑块的影响

Effect of long-term administration of Atorvastatin on carotid atherosclerosis in patients with coronary heart disease

目的观察长期应用阿托伐他汀对冠心病患者颈动脉粥样硬化斑块的影响。方法经冠脉造影证实为冠心病并经超声检查颈动脉有不同程度斑块者44(男28,女16)例,年龄(61±10)岁,给予阿托伐他汀10mg,口服,每晚1次,共2年。每6个月检测1次患者血脂水平,同时用彩色多普勒超声观察患者颈动脉系统内径、内-中膜厚度、斑块大小的变化。结果①治疗6个月后,阿托伐他汀可以使TC、LDL-C水平降低,与治疗前比较有显著性差异(P<0.01);随治疗时间延长,TG水平逐渐降低;HDL-C水平渐升高,但直至治疗18月及24月,才与治疗前有显著性差异。②与治疗前相比,颈动脉内径有所扩大,内-中膜厚度减小,颈动脉斑块缩小。结论阿托伐他汀降脂疗效确切,并有扩大血管内径,减小内-中膜厚度的作用。长期服用阿托伐他汀对冠心病患者的颈动脉粥样硬化斑块有消退作用。

AIM To observe the effect of long-term administration of Atorvastatin on carotid artery atherosclerosis in patients with coronary heart disease （CHD）. METHODS Forty-four patients with CHD and different degrees of carotid plaques detected by coronary artery angiography and ultrasonography [ n = 44, M 28, F 16, mean age： （61 ±10） years] received Atorvastatin 10 mg, po, qn for 2 years. The effects of Atorvastatin on the patients＇lipid parameters including TC, TG, LDL-C and HDL-C were observed and the changes of artery diameter, intima-media thickness （IMT） and artery plaque were observed by carotid color Doppler uhrasonography. RESULTS ①6 months after treatment with Atorvastatin, TC and LDL-C decreased, with significant differences before and after treatment （ P 〈 0.01 ）. The level of HDL-C increased and TG decreased but there was no significant difference until 18 or 24 months.②After treatment, carotid diameter increased, intimamedia thickness was thinner, and the thickness of plaque decreased. CONCLUSION Long-term administration of Atorvastatin has some therapeutic effect and Atorvastatin enlarges the internal diameter of carotid artery and decreases the IMT. Long-term administration of Atorvastatin is effective in the treatment of carotid artery atherosclerosis in CHD patients.