沙利度胺对颈动脉粥样硬化患者血清炎性因子及颈动脉粥样斑块的影响

Effect of thalidomide on the inflammatory factors and carotid artery plaques in carotid atherosclerosis patients

目的观察沙利度胺对颈动脉粥样硬化患者血清炎性因子及颈动脉粥样斑块的影响。方法将80例颈动脉粥样硬化患者随机分为2组,对照组40例予阿司匹林肠溶片治疗,治疗组40例在对照组治疗基础上加沙利度胺片。2组均3个月为1疗程,2个疗程后检测血清炎性因子肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP)水平及颈动脉IMI、斑块变化情况。结果治疗组治疗后血清TNF-α、IL-6、hs-CRP水平及IMT、斑块积分均较本组治疗前明显降低(P<0.05),且低于对照组治疗后(P<0.05),且治疗组治疗后不稳定性斑块减少,稳定性斑块增加,而对照组未见明显变化。结论颈动脉粥样硬化患者采用沙利度胺治疗,能有效降低炎性因子水平,在一定程度改善颈动脉粥样硬化。

Objective To investigate the effect of thalidomide on the inflammatory factors and carotid artery plaques in patients with carotid artery atherosclerosis. Methods 80 patients diagnosed by Color Doppler ultrasound with carotid artery plaques and abnormal intima media thickness （IMT） were randomly divided into treatment group and control group,with each group 40 cases. The treatment group was given Thalidomide 50 mg/d, both of the two groups were given enteric coated Aspirin 75 mg/d with a lifestyle intervention at the same time. The serum level of tumor necrosis factor -α（ TNF - α） , inter leukin - 6 （ IL - 6 ） , high - sensitive C -reactive Protein （ hs - CRP） and the carotid artery IMT, the plaque score and plaque changes were observed before and after treatment of six months. Results Compared with control group and with those before the treatment, the level of TNF -α, IL - 6, hs - CRP in treatment group was decreased obviously after six months of treatment （ P 〈 O. 05 ）, which situation can also be found in the carotid IMT and the plaque score （ P 〈 0. 05 ）, and 29% of unstable plaques changed into stable plaques. Conclusion Thalidomide on patients with carotid atherosclerosis can effectively decrease their inflammato- ry factors and therefore ameliorate carotid artery atherosclerosis.