高危冠心病患者长期强化降脂治疗对颈动脉内膜中层厚度的影响

Effect of Long Term Lowing Lipid on Carotid Arteries Intima-media Thickness in High Risk Patients with Coronary Heart Disease

目的:观察长期降脂治疗的安全性以及对颈动脉中层内膜厚度的影响。方法:我院门诊长期服用辛伐他汀2年的冠心病心肌梗死或冠心病合并糖尿病患者56例,给予辛伐他汀40 mg/d 1年,观察治疗前后颈动脉中层内膜厚度、胆固醇、丙氨酸转氨酶、血肌酐变化。并随访1年的不良反应以及心血管事件。结果:胆固醇水平治疗前(3.86±1.34)mmol/L,治疗后(3.00±0.91)mmol/L,P=0.000;颈动脉中层内膜厚度治疗前(1.28±0.16)mm,治疗后(1.14±0.17)mm,P=0.000;治疗前后丙氨酸转氨酶和血肌酐无明显变化。结论:①长期服用辛伐他汀可以进一步降低胆固醇水平;②长期服用辛伐他汀40 mg/d可以减少颈动脉中层内膜厚度,逆转动脉粥样硬化;③长期服用辛伐他汀40 mg/d安全。

Objective：To observe the safety and effect of long term lowing lipid on carotid arteries intimamedia thickness（[MT）. Method： 56 cases of outpatient with myocardial infarction or coronary heart disease with diabetes in our hospital were taking simvastatin for 2 years. Simvastatin（40 rag/d） should been given for lyear. The change before and after treatment of IMT, level of cholesterol（CHO）, alanine aminotransferase（ALT）, creatinine（Cr） were observed. The side effect and event of cardiovascular were followed up. Results： The level of cholesterol were（3.86 ± 1.34）mmol/L and（3.00 ± 0.91 ）mmol/L before and after treatment, P = 0. 000 ; IMT were（1.28 ± 0.16）mm and（1.14 ± 0.17）mm before and after treatment, P = 0. 000; There were no difference before and after treatment in ALT and Cr. Conclusion： （1）Long - term administration of simvastatin could further lower the level of cholesterol. （2）Long - term administration of simvastatin could reduce IMT and reverse atheroscterosis. （3）Long - term administration of simvastatin with 40 mg/d was salty.