不同剂量阿托伐他汀对伴有高脂血症的稳定型心绞痛患者颈动脉斑块的影响

Effects of different doses of atorvastatin on carotid plaques in patients with stable angina pectoris with hyperlipidemia

目的探讨不同剂量阿托伐他汀对伴有高脂血症的稳定型心绞痛患者颈动脉斑块的影响。方法选取本院2015年9月~2017年9月收治的62例伴有高脂血症的稳定型心绞痛患者为研究对象,根据阿托伐他汀不同剂量分为两组,分别为对照组(阿托伐他汀10 mg/d)和观察组(阿托伐他汀40 mg/d),各31例。治疗6个月后,对两组患者治疗前后的血脂情况、颈动脉阻力指数(CARI)、颈动脉搏动指数(CAPI)、内膜中膜厚度(CIMT)及心血管事件发生情况进行比较。结果治疗后,两组患者的TC、LDL-C、TG、hs-CRP均显著下降,且观察组的TC、LDL-C、TG、hs-CRP下降程度,明显优于对照组,差异具有统计学意义(P<0.05);两组患者的HDL-C显著上升,且观察组的HDL-C上升程度,明显优于对照组,差异具有统计学意义(P<0.05)。对照组患者治疗前后的CIMT、CARI和CAPI相比,差异具有统计学意义(P<0.05)。观察组患者治疗前后的CIMT、CARI和CAPI相比,差异具有统计学意义(P<0.05)。治疗后,两组患者的CIMT、CARI和CAPI相比,差异具有统计学意义(P<0.05)。观察组患者心绞痛的发生率为6.45%,对照组为29.03%,观察组患者心绞痛的发生率明显低于对照组患者,差异具有统计学意义(P<0.05)。结论阿托伐他汀40 mg/d治疗伴有高脂血症的稳定型心绞痛患者,能有效延缓颈动脉斑块的进展,甚至有逆转颈动脉斑块的可能。

Objective To investigate the effect of different doses of atorvastatin on carotid plaques in patients with stable angina pectoris with hy-perlipidemia. Methods 62 patients with stable angina pectoris with hyperlipidemia in our hospital from September 2015 to September 2017 were selectedand divided into two groups according to the different doses of atorvastatin, the control group （atrovastatin 10 mg/d） and the observation group（atrovastatin 40 mg/d）, 31 patients in each group. After 6 months of treatment, the blood lipid, carotid artery resistance index （CARI）, carotid arterypulsation index （CAPI）, intima media thickness （CIMT） and cardiovascular events were compared before and after treatment in the two groups.Results After treatment, the TC, LDL-C, TG and hs-CRP decreased significantly in the two groups, and the degree of TC, LDL-C, TG and hs-CRPin the observation group was obviously superior to the control group. The difference was statistically significant （P〈0.05）; the HDL-C of the twogroups increased significantly, and the HDL-C ascending degree of the observation group was obviously superior to the control group. The differencewas obviously better than the control group. It was statistically significant （P〈0.05）. The difference of CIMT, CARI and CAPI before and after treatmentin the control group was statistically significant （P〈0.05）. The difference of CIMT, CARI and CAPI before and after treatment in the observationgroup was statistically significant （P〈0.05）. After treatment, the difference of CIMT, CARI and CAPI between the two groups was statisticallysignificant （P〈0.05）. The incidence of angina in the observation group was 6.45%, and the control group was 29.03%. The incidence of angina inthe observation group was significantly lower than that of the control group. The difference was statistically significant （P〈0.05）. Conclusion Atorvastatin40 mg/d in patients with stable angina pectoris with hyperlipidemia can effectively delay the progression of carotid artery plaque and even reversethe possibility of carotid plaque.