阿托伐他汀干预下肢动脉硬化闭塞症腔内治疗后再狭窄的研究

Study of the arterial restenosis after intracavitary therapy of the lower extremity atherosclerotic occlusive disease by atorvastatin

目的 探讨阿托伐他汀对下肢动脉硬化闭塞症腔内治疗后再狭窄的干预作用.方法 2008年1月至2010年1月118例在我院行腔内治疗（球囊扩张、支架植入联合内膜剥脱及取拴）的患者随机分为对照组（60例）和阿托伐他汀组（58例）,阿托伐他汀组每日1次口服阿托伐他汀20 mg.观察2组治疗前,治疗后第1天,治疗后4、12、24周的血脂、C-反应蛋白（CRP）、下肢动脉内-中膜厚度（IMT）及血管的通畅率.结果 2组腔内治疗的成功率分别为98.33%（59/60）和100.00%（58/58）,2组血管通畅率随时间延长有不同程度的减低,对照组明显减低,阿托伐他汀组无明显变化,随访24周后对照组的血管通畅率（77.96%,46/60）明显低于阿托伐他汀组（94.82%,55/58）（χ^2=7.88,P＜0.01）.对照组患者腔内治疗的血脂、CRP、IMT指标均有不同程度的增高,但无统计学意义（P＞0.05）,阿托伐他汀组服用阿托伐他汀4周后开始下降,24周后与对照组比较显著下降（P均＜0.01）.结论 阿托伐他汀对下肢动脉硬化闭塞症腔内治疗术后再狭窄有预防作用.

Objective To evaluate the intervention effect of atorvastatin on the arterial restenosis after intracavitary therapy of the lower extremity atherosclerotic occlusive disease. Methods One hundred and eighteen patients who undertook intracavitary therapy （including Balloon dilation, Stent implantation and endarterectomy, Stent implantation and thrombectomy） in our hospital from January 2008 to January 2010 were divided into two groups randomly,60 cases into the control group,and 58 cases into the atorvastatin group whom were orally medicated with Atorvastatin 20 mg once daily. Blood lipid, C-reactive protein, Intima-media thickness and the patency rate of lower limb artery of two groups were observed and recorded before treatment and at 4 weeks, 12 weeks, 24 weeks after treatment. Results Success rates of intracavitary therapy were 98. 33% （59/60） and 100. 00% （58/58） in the control and atorvastatin group respectively. The patency rate decreased in different degree with time in both groups, which decreased more significantly in the control group but remained relatively stable in the atorvastatin group. By follow up we found that the patency rate in the control group was significantly lower than that of in the Atorvastatin group（77.96% vs 94. 82% ,P 〈 0. 01 ）at 24 weeks. Blood lipid, C-reactive protein, Intima-media thickness and the patency rate of lower extremity artery of control group increased in different degrees, but with no statistical significance （P 〉0. 05 ） ,while these indices began to decrease in atorvastatin group after 4 weeks of medication and were significantly lower than the control group （ P 〈 0. 01 ）. Conclusions Atorvastatin has effect on preventing the arterial restenosis after intracavitary therapy of the lower extremity atherosclerotic occlusive disease.