超声造影评价瑞舒伐他汀与阿托伐他汀对颈动脉斑块新生血管的影响

Effects of rosuvastatin and atorvastatin on carotid plaque neovascularization using contrast-enhanced ultrasonography

目的应用超声造影评价瑞舒伐他汀与阿托伐他汀对颈动脉软斑块新生血管的治疗效果。方法选取颈动脉软斑块患者80例,其中27例服用瑞舒伐他汀10 mg/d进行降脂治疗(瑞舒伐他汀组),26例服用阿托伐他汀20 mg/d进行降脂治疗(阿托伐他汀组),另27例未进行降脂治疗(对照组);各组研究期间均给予饮食控制、降血压、控制血糖及常规服用抗血小板药等治疗。治疗6个月后,测量比较三组研究前后血脂检查、常规超声及超声造影相关指标。结果瑞舒伐他汀组及阿托伐他汀组血清总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)水平均显著低于治疗前和对照组,差异均有统计学意义(均P<0.05);瑞舒伐他汀组TC和LDL-C水平显著低于阿托伐他汀组,差异均有统计学意义(均P<0.05),但两组间TG水平比较差异无统计学意义。瑞舒伐他汀组及阿托伐他汀组治疗后斑块积分、增强强度(EI)及时间-强度曲线下面积(AUC)均显著低于治疗前和对照组,差异均有统计学意义(均P<0.05);瑞舒伐他汀组斑块积分、EI及AUC均显著低于阿托伐他汀组,差异均有统计学意义(均P<0.05)。结论瑞舒伐他汀及阿托伐他汀均有确切降脂作用,均可有效减少颈动脉软斑块内的新生血管,且瑞舒伐他汀作用强于阿托伐他汀。超声造影可用于评价药物干预颈动脉粥样硬化斑块的治疗效果。

Objective To evaluate the therapeutic effects of rosuvastatin and atorvastatin on neovascularization of carotid plaques using contrast-enhanced ultrasonography. Methods A total of 80 patients with carotid artery soft plaques were enrolled. Twenty-seven patients were treated with rosuvastatin 10 mg/d（the rosuvastatin group）,26 patients with atorvastatin 20 mg/d（the atorvastatin group） for 6 months. Another 27 patients were not taking any statins（the control group）. Each group during the study was given treatment such as diet control,lowering blood pressure,controlling blood sugar,conventional anti-platelet drugs. The level of serum lipid,routine ultrasonography and contrast-enhanced ultrasonography were used to evaluate therapeutic effects before and after treatment. Results The total cholesterol（TC）,triglycerides（TG） and low-density lipoprotein cholesterol（LDL-C） levels in the rosuvastatin group and the atorvastatin group were significantly lower than those before treatment（all P〈0.05）, and also lower than those in control group （all P〈0.05）. The TC and LDL-C in the rosuvastatin group were significantly lower than those in astorvastatin group （all P〈0 . 05）, but there was no significant difference in TG between the two groups . The plaque score,enhanced intensity（EI） and area under the time-intensity curve（AUC） in the rosuvastatin group and the atorvastatin group were significantly lower than those before treatment,and also lower than those in control group,there were significant difference（all P〈0.05）. The plaque score,EI and AUC of rosuvastatin group were also significantly lower than those of atorvastatin group（all P〈0.05）. Conclusion Rosuvastatin and atorvastatin have definite lipid-lowering effect,and can effectively reduce the neovascularization in carotid plaques . The effect of rosuvastatin is stronger than that of atorvastatin . Contrast-enhanced ultrasonography can evaluate the therapeutic effects of carotid artery plaques by drug intervention.