冠状动脉CT血管成像在冠状动脉粥样硬化患者降脂治疗中的应用

Application of Coronary CT Angiography in the Lipid-Lowering Therapy of Patients with Coronary Atherosclerosis

目的探讨冠状动脉CT血管成像(CCTA)在冠状动脉粥样硬化患者降脂治疗中的应用。方法选取2016年1月至2018年1月期间本院收治的冠状动脉管腔狭窄程度≤50%的冠心病患者108例,根据阿托伐他汀钙治疗剂量不同分为非强化他汀组(n=56)和强化他汀组(n=52)。非强化他汀组采用10mg阿托伐他汀钙治疗,强化他汀组采用20mg阿托伐他汀钙治疗。比较治疗前后两组血脂代谢相关指标水平及CCTA检查斑块数据。结果治疗后,强化他汀组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平、低密度斑块、斑块总体积及斑块体积百分比均低于非强化他汀组(P<0.05);TC、LDL-C与斑块总体积呈正相关(r1=0.524,r2=0.510,P<0.05),与斑块体积百分比呈正相关(r1=0.487,r2=0.459,P<0.05);TC和LDL-C是影响斑块总体积大小和斑块体积百分比的独立危险因素(P<0.05)。结论强化剂量阿托伐他汀钙能有效降低血脂,CCTA检查能评价斑块情况,监测药物治疗疗效。

Objective To explore the application of coronary computed tomography angiography(CCTA)in the lipid-lowering therapy of patients with coronary atherosclerosis.Methods 108 patients with coronary heart disease with≤50%coronary luminal stenosis in the hospital from January 2016 to January 2018 were selected and divided into non-intensive statin(n=56)and intensive statin group(n=52)according to the different treatment doses of atorvastatin calcium.The non-intensive statin group were treated with 10mg atorvastatin calcium,and the intensive statin group were treated with 20mg atorvastatin calcium.The levels of blood lipid metabolism-related indicators and CCTA plaque data were compared between the two groups before and after treatment.Results After treatment,the levels of total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),the low-density plaque,total plaque volume and plaque volume percentage in the intensive statin group were lower than those in the nonintensive statin group(P<0.05).TC and LDL-C were positively correlated with the total plaque volume(r1=0.524,r2=0.510,both P<0.05),and were positively correlated with plaque volume percentage(r1=0.487,r2=0.459,both P<0.05).TC and LDL-C were independent risk factors for total plaque volume and plaque volume percentage(P<0.05).Conclusion Intensive dose of atorvastatin calcium can effectively reduce blood lipids.CCTA examination can evaluate plaque and monitor the treatment efficacy of drugs.