氟伐他汀对颈动脉内膜增厚的治疗效果

Therapeutic effect of fluvastatin on carotid intima-media thickening

目的:观察氟伐他汀预防颈动脉内膜中层厚度(CIMT)增厚的效果。方法:选择年龄45岁以上、低冠心病危险、CIMT增厚(1.2～3.5mm)、低密度脂蛋白胆固醇(LDL-C)浓度升高的540例患者,随机均分为安慰剂对照组和氟伐他汀组。观察两组治疗前后血脂水平变化以及最大CIMT变化率、CIMT进展情况等。结果:治疗两年后,与安慰剂对照组比较,氟伐他汀组总胆固醇[(6.18±0.13)mmol/L比(5.03±0.81)mmol/L]、甘油三酯[(2.45±0.72)mmol/L比(1.97±0.56)mmol/L]、LDL-C[(4.09±1.81)mmol/L比(2.95±1.10)mmol/L]水平均明显降低(P<0.05或<0.01),高密度脂蛋白胆固醇[(1.04±0.32)mmol/L比(1.25±0.30)mmol/L]水平明显升高,P<0.05;CIMT[(0.989±0.373)mm比(0.748±0.220)mm],CIMT进展率(0.0131mm/年比0.0014mm/年)明显减小(P<0.05,P<0.001)。结论:对于具有动脉硬化证据的中老年人,氟伐他汀能够显著降低低密度脂蛋白胆固醇水平,颈动脉内膜中层厚度及其进展率。

Objective： To observe the therapeutic effect of fluvastatin on carotid intima-media thickening. Methods： A total of 540 patients with age 〉45 years and low risk of coronary heart disease, their carotid intima-media thick-ness （CIMT） was 1.2-3.5mm and low density lipoprotein cholesterol （LDL-C） level elevated, were randomly and equally divided into placebo control group and fluvastatin group. Changes of blood lipid levels, CIMT and CIMT progression were observed in two groups before and after treatment. Results： Compared with placebo control group after two-year treatment, there were significant decrease in levels of total cholesterol [ （6.18 ± 0.13） mmol/L vs. （5.03 ± 0.81） mmol/L], triglyceride [ （2.45 ± 0.72） mmol/L vs. （1.97 ± 0.56） mmol/L] and LDL- C E （4.09 ± 1.81） mmol/L vs. （2.95 ± 1.10） mmol/L], P〈0.05 or 〈0.01, and significant increase in level of high density lip-oprotein cholesterol [ （1.04 ± 0.32） mmol/L vs. （1.25 ± 0.30） mmol/L], P〈0.05 ; and significant decrease in CI-MT E （0. 989 ± 0. 373） mm vs. （0. 748 ± 0. 220） mm] and progression rate of CIMT （0. 0131 mm/year vs. 0. 0014 mm/year） in fluvastatin group, P〈0.05, P〈0. 001. Conclusion： For middle-aged and aged people with athero-sclerosis evidence, fluvastatin can significantly decrease low density lipoprotein cholesterol level and progressive rate of carotid intima-media thickening.