阿托伐他汀联合维生素E治疗颈动脉斑块的疗效及机制分析

THE CURATIVE EFFECT OF ATORVASTATIN COMBINED VITAMIN E IN CAROTID PLAQUES AND ITS MECHANISM

目的探讨阿托伐他汀片联合维生素E治疗颈动脉斑块和内膜增厚的临床疗效及其机制。方法100例中老年颈动脉斑块患者随机分成对照组和观察组,对照组给予阿托伐他汀和拜阿司匹林肠溶片治疗;观察组在对照组治疗的基础上加用维生素E治疗,二组疗程均为6个月。彩色多普勒超声诊断仪检测颈动脉内膜中层厚度(CIMT)变化情况,同时检测患者治疗前后胆固醇、低密度脂蛋白和氧化应激参数(丙二醛和谷胱甘肽)的改变。结果观察组的颈动脉斑块和内膜增厚度改善明显优于对照组(P<0.05),总有效率为88%,明显高于对照组的68%,且二组均无明显不良反应。二组治疗后血脂均较治疗前明显降低,但是二组之间差异无统计学意义(P>0.05),观察组治疗后丙二醛(MDA)较治疗前明显降低(P<0.05),谷胱甘肽(GSH)较治疗前明显增高(P<0.05)。结论阿托伐他汀联合维生素E治疗颈动脉斑块和内膜增厚疗效确切,无明显不良反应,其治疗机制可能和改善体内的氧化应激状态有关。

Objective To study the curative effect and mechanism of Atorvastatin combined vitamin E in ca- rotid plaques. Methods One hundred cases of middle- aged and eldly carotid plaques were randomly divid-ed into control group and observation group, the control group was given Atorvastatin and Aspirin enteric - coated treatment, while the observation group was given vitamin E on the basis of the control group ther- apy, the course was 6 months. The changes of carotid intima- media thickness （CIMT） were tested by color Doppler ultrasonic. At the same time, cholesterol （TC）, low- density lipoprotein cholesterol （LDL） and oxidative stress parameters change were detected before and after treatment. Results The carotid plaques and CIMT of the observation group were improved significantly better than that of control group （P〈0. 05）, the total effective rate was 68%, significantly higher than the control group 68%, and there were no obvious adverse reactions between the two groups. The TC and LDL were significantly lower than before treatment, but the gap between the two groups had no statistical significance （P〉0. 05 ）; After treatment, The malondialdehyde （MDA） was significantly lower than before treatment （P〈0.05）, gluta- thione （GSH） significantly increased than before treatment （P〈0.05）. Conclusion The curative effect of Atorvastatin combined vitamin E in carotid plaques is ment mechanism may be related to improve oxidative definite, and no obvious adverse reactions, the treat stress state in the body.