普伐他汀治疗对颈动脉粥样硬化患者血浆高敏C反应蛋白的影响

Effect of pravastatin on plasma hs-C-reactive protein in patients with carotid atherosclerosis

目的 观察颈动脉粥样硬化患者血浆超敏C反应蛋白（hs-CRP）的变化及普伐他汀治疗对其的影响,探讨他汀类药物预防缺血性脑血管病的可能机制.方法 选择颈动脉粥样硬化患者70例,随机分为药物干预组（A组）和非药物干预组（B组）.A组在控制饮食的基础上给予口服普伐他汀20 ng,1次/日,疗程16周.B组则采用物理治疗如控制饮食、体育锻炼、减轻体重等方法.干预8周后观察血脂及血浆hs-CRP的变化,8周、16周后复查颈动脉多普勒超声,并进行统计分析.结果 干预8周后A组血脂、hs-CRP水平较前明显下降（P＜0.01）,且低于B组（P＜0.05）;干预8周后两组患者颈动脉粥样硬化斑块无明显变化,16周后A组颈动脉粥样硬化斑块明显变小,且易损斑块减少.结论 他汀类药物在治疗颈动脉粥样斑块中不仅有降脂作用,还可以降低血浆hs-CRP水平,具有抗炎、稳定斑块及预防缺血性脑血管病的作用.

Objective To observe the pravstatin on carotid atherosclerotic plaques and plasma high sensitive C-reactive protein （hs-CRP） in paitents with carotid atherosclerosis. Methods From May 2007 to October 2008 seventy patients with carotid atherosclerosis were selected from Renmin Hospital of Wuhan University and divided randomly into two groups ：pravstatin intervention group （n = 35 ） treated with pravstatin based on diet control and normal intervention group （ n = 35 ） received diet control and athletic sports for 16 weeks. The changes of plasma hs-CRP and blood lipid were observed after treatment for 8 weeks and 16 weeks. Carotid Doppler ultrasonography was carried out. Results The leves of blood lipid and plasma hs-CRP in intervention groups were higher than that in control group （ P 〈 0.05 ）. After treatment for 8 weeka,the levels of blood lipid and plasma hs-CRP in pravstatin intervention groups were lower than that in normal intervention group （ P 〈 0.05 ）. After treatment for 16 weeks, the carotid atheroselerotic plaque size and vulnerable plaque rate reduced in pravstatin intervention groups （ P 〈 0.05 ）. Conclusion Pravstatin has preventive effect on stroke by stabilizing atherosclerotie plaques, reducing the hs-CRP level and lipid in patients with carotid atheroselerosis.