沙利度胺抑制动脉粥样硬化的临床效应

Effect of thalidomide on inhibiting atherosclerosis in clinic

目的研究沙利度胺(Thd)对动脉粥样硬化(AS)病变形成的抑制作用。方法选择经超声检查证实存在AS的患者80例作为研究对象,随机分为Thd组和对照组,每组40例。2组患者均给予肠溶阿司匹林75 mg·d-1,并给予一定的生活方式干预;在此基础上Thd组患者给予Thd 50 mg·d-1。2组患者于治疗前及治疗后6个月测定血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)和血脂水平,并观察AS情况。结果治疗6个月后,2组患者血脂水平与治疗前比较差异无统计学意义(P>0.05);Thd组患者血清TNF-α、IL-6、hs-CRP水平较对照组及治疗前均明显降低,差异有统计学意义(P<0.05,P<0.01);治疗6个月后Thd组患者颈动脉内-中膜厚度、斑块积分较对照组及治疗前均明显降低,差异有统计学意义(P<0.05,P<0.01);Thd组患者中有29.6%不稳定斑块转变为稳定斑块。结论 Thd具有抑制AS形成的作用,其机制可能是通过下调血清炎性因子表达而非降脂效应抑制AS的形成。

Objective To study the effect of thalidomide （Thd） inhibiting atherosclerosis in clinic. Methods Eighty patients diagnosed by color Doppler ultrasound with atherosclerosis were randomly divided into Thd group and control group, with 40 cases in each group. Both of the two groups were given enteric-coated aspirin 75 mg d^- 1 with a lifestyle intervention. Based on this,Thd group was given Thd 50 mg d-1. The serum level of tumor necrosis factor-α（TNF-α） ,interleukin-6（ IL- 6） ,high-sensitive C-reactive protein（hs-CRP） and serum lipid were measured before and after treatment of six months. The atheroselerosis condition also was observed. Results Compared with before treatment, there was no statistical significance in the indexes of blood lipid six months after treatment（ P 〉 0.05 ）. The levels of TNF-α, IL-6 and hs-CRP in Thd group were lower than those in the control group or than before treatment, the differences had statistical significance （P 〈 0.05, P 〈 0.01 ） , which situation could also be found in the carotid intima-media thickness and the plaque score （P 〈 0.05, P 〈 0. 01 ）, and 29. 6% of unstable plaques changed into stable plaques. Conclusion Thd can inhibit atherosclerosis by lowing the expression of inflammatory factors probably, which has no relationship with lipid metabolism regulation.