硫辛酸联合他汀类药物治疗老年人动脉粥样硬化的疗效观察

Efficacy of combination therapy of lipoic acid and statins for atherosclerosis in the elderly

目的：观察并评价硫辛酸联合他汀类药物治疗老年人动脉粥样硬化的疗效。方法选取2014年9月至2015年9月期间第四军医大学第一附属医院老年病科收治的动脉粥样硬化患者80例，将其随机分成硫辛酸组（ n＝40）和对照组（n＝40）。对照组口服阿托伐他汀钙等常规药物；硫辛酸组在对照组基础上联合使用硫辛酸。6个月后，比较两组患者治疗前后在血脂指标上的疗效及颈部超声、四肢动脉硬化的改变，包括甘油三脂（ TG ）、总胆固醇（ TC ）、低密度脂蛋白胆固醇（ LDL-C）、高密度脂蛋白胆固醇（ HDL-C）、超敏C－反应蛋白（ hs-CRP）、颈内动脉内膜中层厚度（ IMT）及肱－踝动脉脉搏波传导速度（baPWV）。结果两组患者治疗6个月后与治疗前比较，TG、TC、LDL-C、HDL-C、hs-CRP及IMT、baPWV的改善均达到统计学意义，且硫辛酸组各项指标的改善程度均优于对照组，差异具有统计学意义（P＜0．05）。两组患者均出现不同程度不良反应，但差异无统计学意义，且采取适当措施后均得以缓解。结论硫辛酸联合他汀类药物可以降低老年人动脉粥样硬化血液相关指标TG、TC、LDL-C、hs-CRP，升高HDL-C，改善IMT和baPWV，临床疗效好，且无严重不良反应，值得在临床中推广及应用。

Objective To observe and evaluate the efficacy of combined lipoic acid and statins in the elderly who suffered from atherosclerosis .Methods A total of 80 patients with atherosclerosis from Department of Geriatrics of our hospital during September 2014 and September 2015 were recruited in this study .They were randomly divided into control group and lipoic acid group , with 40 cases in each group .The control group received conventional drugs such as atorvastatin calcium , while the lipoic acid group took lipoic acid preparations besides the conventional drugs .The efficacy were evaluated by determining the blood lipid levels , such as tryglycerides （ TG ） , total cholesterol （ TC ） , low-density lipoprotein cholesterol （ LDL-C ） , high-density lipoprotein cholesterol （ HDL-C） , and high sensitivity C-reactive protein （ hs-CRP ） , and by carotid internal artery intima-media thickness （ IMT ） and brachial-ankle artery pulse wave velocity （ baPWV ） through carotid color Doppler ultrasound and arteriosclerosis in four limbs in 6 months after the treatment.Results The levels of TG, TC, LDL-C, hs-CRP, IMT and baPWV were greatly improved in the both groups after 6 months ’ treatment when compared with the values before treatment .What ’ s more, the above results were more significantly in the lipoic acid group than in the control group （all P〈0.05）.There were some adverse reactions in both groups , including infusion site pain , phlebitis , dizziness or headache , hypoglycemia , and purpura , but with no significant difference between the two groups.Conclusion Combination therapy of lipoic acid and statins can reduce the levels of TG , TC, LDL-C and hs-CRP, ele-vate the level of HDL-C, and improve IMT and baPWV .It has good clinical efficacy , causes no serious adverse reactions , and should be promoted for clinical application .