两种剂量他汀对冠脉粥样硬化斑块的作用及其疗效和安全性

Effects of intensive treatment of statin towards atherosclerosis plaques in patients with borderline vulnerable plaque lesion

目的应用血管内超声(IVUS)比较大剂量和常规剂量阿托伐他汀对初发不稳定心绞痛患者冠状动脉临界病变粥样硬化斑块的作用,并观察两种剂量阿托伐他汀的临床疗效和安全性。方法经冠状动脉造影(CAG)显示狭窄程度在50%～70%的临界病变的冠心病初发不稳定心绞痛患者100例,每位患者均行IVUS检查并选取1处狭窄为50%～70%的粥样斑块病变为靶病变,随机分为阿托伐他汀80 mg/d的大剂量治疗组和阿托伐他汀20mg/d的常规剂量对照组,9个月后再次行CAG和IVUS,比较治疗前后斑块体积、管腔体积和血管体积的变化。结果 100例均完成了临床随访,62例完成了整个服药过程及CAG和IVUS复查。结果显示,9个月后对照组斑块体积增大(P<0.05),治疗组未见明显变化(P>0.05)。结论大剂量阿托伐他汀可遏制初发不稳定心绞痛患者冠脉临界病变粥样硬化斑块的进展。

Objective To compare the efficacy and safety of atorvastatin intensive treatment towards borderline vulnerable plaque lesion in unstable angina peetoris （UAP） patients by intravascular ultrasound. Methods A total of 100 pa- tients undergoing coronary angiography （CAG） with borderline lesion （ coronary artery stenosis between 50% ~ 70% ）, who were divided into two groups, the intensive treatment group and the common treatment group. One 50% - 70% stenasis plaque was selected as target plaque in each patient. Coronary artery angiography （CAG） and target plaque intravaseular ultrasound （IVUS） were performed on admission. Nine months later, to compare the plaque volume, lumen volume and vascular volume. Results Nine months later, in common treatment group plaque volume increased （ P 〈 0. 05 ）, but all the indexes showed no significantly changes in intensify statins group （ P 〉 0.05 ）. Conclusion Atorvastatin intensive therapy can prevent the development of atherosclerotie plaque of UAP patients.