他汀类药物对老年冠心病患者冠状动脉非钙化斑块疗效的MSCT评价

Therapeutic evaluation of the non-calcified coronary plaques with the statin by multi-slice spiral computed tomography

目的 利用多层螺旋CT(multi-slice computed tomography, MSCT)评价他汀类药物治疗冠状动脉非钙化斑块的疗效。方法 回顾性分析2016年1月~2017年10月间35例确诊老年冠心病患者的冠状动脉CT造影(coronary computed tomographic angiography, CCTA)图像,每位患者均常规服用他汀类药物后12~15个月复查CCTA,确定每位患者的主要斑块后,利用后处理软件对两次检查进行斑块体积计算,每位患者临床资料及化验数据均记录并统计分析。按他汀治疗组患者的年龄匹配,另选30例老年患者作为对照组。结果 经他汀类药物治疗12~15个月后,治疗组血清胆固醇、甘油三酯水平下降,分别由(4.20±1.30)mmol/L、(1.95±0.93)mmol/L下降至(3.25±1.42)mmol/L、(1.67±1.03)mmol/L,差异具有统计学意义( P <0.05),但高密度脂蛋白、低密度脂蛋白变化无统计学差异( P >0.05)。治疗组主要斑块体积、横断面积均较治疗前缩小,分别由(85.3±17.43)mm ^3、(15.36±2.28)mm ^2下降至(73.4±16.54)mm^ 3、(11.55±3.05)mm ^2,差异有统计学意义( P <0.05)。对照组肇事斑块体积、最大横截面积比较无显著性差异( P >0.05)。结论 MSCT可量化评价冠状动脉非钙化斑块经他汀类药物治疗后的变化,他汀类药物能够有效调整血脂从而逆转或稳定冠状动脉非钙化斑块。

Objective To evaluate the efficacy of statins in the treatment of coronary artery non-calcified plaques by multi-slice spiral CT. Methods The coronary computed tomographic angiography images of 35 elderly patients with coronary heart disease diagnosed by CT from January 2016 to October 2017 were analyzed retrospectively. Computed tomography coronary angiography (CCTA) was performed before treatment and 12~15 months after treatment. Main plaque of each patient was analyzed by post-processing software. They were all written down and analyzed combined with their clinical data. Thirty age-paired patients were enrolled in our study as control group. Results After 12 and 15 months of statins treatment, the levels of serum cholesterol and triglyceride in the treatment group decreased. It decreased from (4.20±1.30) mmol/L and (1.95±0.93) mmol/L to (3.25±1.42) mmol/L and (1.67±1.03) mmol/L, respectively ( P <0.05). However, there was no significant difference between high density lipoprotein and low density lipoprotein ( P >0.05). The volume and cross-sectional area of main plaques in the treatment group were significantly lower than those before treatment, from (85.3±17.43) mm^ 3 and (15.36±2.28) mm ^2 to (73.4±16.54) mm^ 3 and (11.55±3.05) mm ^2, respectively ( P <0.05). There was no significant difference in plaque volume and maximum cross-sectional area in the control group ( P >0.05). Conclusion MSCT can quantitatively evaluate the changes of coronary non-calcified plaques after treatment with statines. Statins can effectively adjust blood lipid and reverse or stabilize coronary non-calcified plaques.