冠心病患者经皮冠状动脉介入治疗术后规范药物治疗对颈动脉粥样硬化的影响

Effects of Standard Medication Treatment on Atherosclerosis of Carotid Artery in Patients with Coronary Artery Disease after Percutaneous Coronary Intervention

目的评价冠心病合并颈动脉粥样硬化患者经皮冠状动脉介入治疗(PCI)术后规范药物治疗对颈动脉粥样硬化的影响,并探讨其可能机制。方法 80例冠心病合并颈动脉粥样硬化患者PCI术后规范抗血小板聚集、他汀降脂等治疗,术前及术后12个月行颈动脉超声检查,测量颈动脉内膜中层厚度(IMT)和粥样硬化斑块积分,对比服药前后12个月内脑血管事件的发生率,测定超敏C反应蛋白、血脂水平、血常规的变化。结果冠心病PCI术后规范治疗12个月与治疗前相比,甘油三酯、总胆固醇、低密度脂蛋白胆固醇、超敏C反应蛋白明显降低(P<0.05),高密度脂蛋白胆固醇有所升高,但无统计学差异(P>0.05);血常规中红细胞计数、白细胞计数、血红蛋白含量治疗前后相比无明显改变(P>0.05),血小板计数较治疗前有所减少,但仍在正常范围,差异无统计学意义(P>0.05);颈动脉IMT和粥样硬化斑块积分均较治疗前明显下降(P<0.05);短暂性脑缺血发作的发作减少(P<0.05)。结论冠心病PCI术后规范药物治疗能明显改善血脂水平,减轻非特异性炎性反应,对颈动脉粥样硬化斑块有延缓和稳定作用,并可减少短暂性脑缺血发作的发生。

Objective To evaluate the effects of standard medication atherosclerosis of common carotid artery in elderly patients with coronary artery disease after percutaneous coronary intervention （PCI）, and explore its possible mechanism. Methods A total of 80 cases of elderly patients with carotid atherosclerosis who received PCI with standard medication were investigated. The standard medication was comprised of antiplatelet aggregation and statin lipid -lowering therapy. Ultrasound imaging was used to detect the changes of carotid artery intima - media thickness （IMT） and artherosclerosis integral before administration and 12 months after administration, and the levels of high sensitivity C-reactive protein, blood fat and routine blood test were recorded and analyzed. Results Twelve months after treatment with standard medication, the levels of triglycefide, total cholesterol, low-density lipoprotein cholesterol and high-sensitivity C-reactive protein were significantly decreased （P 〈 0.05）, while high-density lipoprotein cholesterol was slightly increased （P 〉 0.05 ）. Twelve months after standard medication treatment, there were no significant differences of the counts of red cell, white cell and the hemoglobin content in the blood （ P 〉 0.05 ）. The count of platelet has decreased, but still within the normal range （P 〉 0.05 ）. The IMT and atherosclerosis integral of cartid artery were significantly decreased （ P 〈 0.05 ）. Furthermore, the occurrence frequency of transient ischemic attack was decreased. Conclusion Standard medication treatment after PCI is helpful in patients with coronary heart disease, which can gain the optimization of blood lipid level, reduce non-specific inflammation, and lead to the more steady carotid atherosclerotic plaques and reduced incidence of transient ischemic attack.