辛伐他汀对颈动脉粥样硬化的影响

Influence of simvastatin on carotid atherosclerosis

目的探讨辛伐他汀对颈动脉内膜-中膜厚度及颈动脉粥样硬化斑块的影响。方法用彩色多普勒超声技术,检测出具有不同程度的颈动脉粥样硬化患者48例,给予辛伐他汀20mg每晚口服,共3个月。观察患者治疗前后颈动脉内膜-中膜厚度、颈动脉粥样硬化斑块面积的变化以及血脂水平、丙氨酸转换酶、肌酸激酶的变化和药物不良反应。结果全部患者治疗前共有79个斑块,治疗后54个斑块,斑块消失率32%,其余未消失的斑块面积均有明显缩小(P<0.01);颈动脉内膜-中膜厚度明显缩小(P<0.01),TC、TG、LDL-C明显下降(P<0.01),HDL-C升高(P<0.05),ALT、CK无变化(P>0.05),无明显不良反应。结论彩色多普勒超声能检测出早期颈动脉粥样硬化。辛伐他汀能稳定和消退粥样斑块,调脂疗效确切,从而减少心脑血管事件的发生。

Objective To investigate the influences of simvastatin on carotid artery Intima-media thickness（IMT）and carotid atherosclerotic plaque. Methods 48 patients with different degrees carotid atherosclerosis detected by ultrasonic received simvastatin 20mg per night for 3 months. The carotid artery IMT and carotid atherosclerotic plaques were detected before and after treatment, as well as lipid levels, ALT and CK was determined . The side effects of simvastatin were observed. Results There were 79 plaques in all patients. After 3 months of treatment with simvastatin, 25 plaques vanished respectively and the size of the other 54 plaques decreased significantly（P〈0.01） ,IMT decreased significantly（P〈0.01）. The levels of TC, TG and LDL-C decreased significantly（P〈0.01） ,HDL-C increased（P〈0.05）. There were no changes in ALT and CK and no side effects of simvastatin during treatment. Conclusion Simvastatin can decline the carotid atherosclerotic plaque, lower serum lipid effectively, and then decrease the rates of cardiovascular and cerebrovascular events.