64排螺旋CT评价辛伐他汀对冠状动脉斑块的影响

Influence of simvastatin on coronary plaque evaluated by 64-slice spiral CT

目的通过64排螺旋CT评价辛伐他汀对冠状动脉斑块的影响,对此种检查方式与治疗方式作出客观评价。方法 62例经64层螺旋CT冠状动脉造影检查均存在冠状动脉粥样斑块的患者为研究对象,所有患者均给予辛伐他汀治疗,12个月后复查,对比治疗前后患者的血脂水平及动脉粥样斑块的面积变化情况。结果治疗后患者血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)均较治疗前显著下降,差异均具有统计学意义(P<0.05);治疗前后高密度脂蛋白胆固醇(HDL-C)水平比较差异无统计学意义(P>0.05)。62例患者共检查189支冠状动脉主要分支,共发现不同程度动脉斑块219个,其中脂质斑块79个,纤维斑块53个,钙化斑块52个,混合斑块35个。治疗后脂质斑块、纤维斑块及混合斑块的面积均较治疗前明显减小,差异均具有统计学意义(P<0.05);治疗前后钙化斑块面积比较差异无统计学意义(P>0.05)。结论辛伐他汀可下调血清血脂水平,有效缩小冠状动脉粥样斑块面积;应用64层螺旋CT可对冠状动脉粥样斑块进行定量与定性分析,可由此对辛伐他汀的临床疗效作出客观判断与分析。

Objective To evaluated the influence of simvastatin on coronary plaque evaluated by 64-slice spiral CT, and made an objective evaluation on this checking method and treatment method. Methods A total of 64 coronary artery atherosclerotic plaque patients detected by 64-slice spiral CT as study subjects, and they all received simvastatin for treatment. Patients were reexamined in 12 months, and their lipid levels and area of the artery atheromatous plaque before and after treatment were compared. Results After treatment, patients had obviously lower serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) than before treatment, and the difference had statistical significance (P<0.05). There was no statistically significant difference in high density lipoprotein cholesterol (HDL-C) level before and after treatment (P>0.05). 189 coronary artery main branches were checked in 62 patients, and 219 different degree of arterial plaques were found,including 79 lipid plaques, 53 fibrous plaques, 52 calcified plaques and 35 mixed plaques. Patients had smaller area of lipid plaques, fibrous plaques and mixed plaques after treatment than before treatment, and the difference had statistical significance (P<0.05). There was no statistically significant difference in calcified plaques area before and after treatment (P>0.05). Conclusion Simvastatin can lower serum lipid levels and effectively narrow coronary artery atheromatous plaque area; Application layer 64 spiral CT for coronary artery atheromatous plaque area. Application of 64-slice spiral CT can make quantitative and qualitative analysis for coronary artery atheromatous plaque, so as to make objective judgment and analysis for clinical curative effect of simvastatin.