弹性应变率比值评价阿托伐他汀稳定颈动脉粥样斑块中短期疗效研究

Evaluation of the medium and short term efficacy of atorvastatin in stabilizing carotid atherosclerotic plaques by elastic strain rate ratio

目的观察用弹性应变率比值法评价中短期稳定斑块疗效。方法选择颈总动脉斑块患者80例,分为A、B两组,A组患者每日给予阿托伐他汀20mg,B组患者每日给予阿托伐他汀40mg,分别于治疗前及治疗后3个月、6个月进行斑块弹性应变率比值测定。同时监测血清低密度脂蛋白-胆固醇(LDL-C)、高密度脂蛋白-胆固醇(HDL-C)、高敏C反应蛋白(hsCRP)浓度。结果⑴治疗3个月后A、B两组血清LDL-C、hs-CRP浓度较治疗前明显降低,差异有统计学意义(A组P<0.05,B组P<0.01),HDL-C较治疗前升高,A组无明显统计学差异,B组差异有统计学意义(P<0.05),治疗6个月后两组LDL-C、hs-CRP继续下降,但与3个月相比无明显统计学差异,HDL-C与3月比无明显变化。⑵A组治疗3个月后斑块弹性应变率比值较治疗前升高,但无统计学差异,6个月后较治疗前升高有统计学差异(P<0.05),但与3个月比无统计学差异;B组治疗3个月后斑块弹性应变率比值较治疗前明显升高,有统计学差异(P<0.05),治疗6个月继续升高,但与3个月相比无明显统计学差异。结论⑴应变率比值法可对斑块的硬度进行客观评价。⑵每日阿托伐他汀40mg比20mg更快增加斑块硬度从而稳定斑块,但远期疗效相差不明显。

Objective After the treatment of common carotid artery plaque with different doses of atorvastatin,the medium and short-term effects of stable plaque were evaluated by elastic strain rate ratio method. Methods Eighty patients with common carotid plaque were selected and divided into two groups,A and B. Group A patients received atorvastatin 20mg daily. Group B patients received atorvastatin 40mg daily. The plaque elastic strain rate ratio was measured before treatment and three months and six months after treatment. Serum low density lipoprotein-cholesterol (LDL-C),high density lipoprotein-cholesterol (HDL-C) and high sensitive C reactive protein(hs-CRP) concentrations were also monitored. Results ⑴After 3 months of treatment,the concentrations of serum LDL-C and hs-CRP in group A and group B were significantly lower than those before treatment. The difference was statistically significant (in group A<0.05,in group B<0.01). HDL-C was higher than before treatment,and there was no statistical difference in group A. The difference between group B was statistically significant(P<0.05). After 6 months of treatment,LDL-C and hs-CRP continued to decrease in the two groups,but there was no statistically significant difference compared with 3 months. There was no significant change in HDL-C compared with 3 months.⑵The ratio of plaque elastic strain rate after treatment in group A was higher than that before treatment,but there was no statistical difference. After 6 months,there was a statistical difference(P<0.05),but there was no statistical difference from 3 months. The ratio of plaque elastic strain rate after treatment in group B was significantly higher than that before treatment (P<0.05). The treatment continued to increase in 6 months,but there was no statistical difference compared with 3 months. Conclusion ⑴The elastic strain rate ratio method can objectively evaluate the hardness of plaque.⑵Daily atorvastatin 40mg faster than 20mg to increase plaque hardness to stabilize plaque,but the long-term efficacy is not obvious.