阿托伐他汀治疗颈动脉粥样硬化斑块的临床研究

Clinical study of atorvastatin therapy in patients with carotid atherosclerosis plaques

目的研究阿托伐他汀对颈动脉粥样硬化斑块的疗效。方法应用彩色多普勒超声检出颈动脉粥样硬化斑块形成者259例,随机分为对照组(常规治疗)和治疗组(常规治疗加口服阿托伐他汀),观察治疗前后颈动脉内膜中层厚度(IMT)、斑块回声性质、大小的变化,并与对照组比较。结果治疗组和对照组6个月IMT分别为(0.914±0.069)和(1.1±0.141),12个月IMT分别为(0.829±0.076)和(1.114±0.16),两组比较差异有统计学意义(P<0.05)。斑块数量治疗组和对照组比较差异无统计学意义(P>0.05),斑块的大小低于治疗前,但与对照组比较差异无统计学意义。治疗组斑块的厚度较对照组和治疗前均有变薄,治疗12个月差异有统计学意义。软斑数量治疗组较对照组也有减少,差异有统计学意义。结论阿托伐他汀具有隐定和缩减颈动脉粥样硬化斑块的作用,能减缓颈动脉粥样硬化的进展,而且随着治疗时间的延长,抗动脉粥样硬化及稳定斑块的作用更加明显。

Objective To investigate the effects of atorvastatin on carotid atherosclerosis plaques. Methods 259 patients with carotid atherosclerosis plaques were selected, and they were divided into atorvastatin （20 mg/d） group （treatment group, n = 123） and control group （without atorvastatin,n = 129）. 6,12 months after the treatment. The intima-media thickness （IMT） of bilateral carotid arteries and plaque morphology were evaluated with carotid ultrasound examination. Results The IMT in the treatment and control groups at 6 month were（0.914±0.069） and （ 1.1 ±0. 14）, at 12 month were（0. 829±0.076） and （1.114±0. 16）, respectively, There were significant differences between the two groups （P 〈 0.05 ）. The number of carotid plaques were not statistically significant in two groups before and after treatment （P〉0. 05）. After treatment with atorvastatin the size of plaque decreased, but the difference was not statistically significant compared with control group. At 12 month the thickness of plaques were thinner in treatment group than control group （P〉0.05）. The plaques of fibrous cap and fatty decreased in treatment group compared with control group （P〉0.05）. Conclusions Atorvastatin is effective to stabilize carotid atherosclerosis plaques and prevent the progression of plaques. Long-term adiministration of atorvastatin is attended with good results.