阿托伐他汀联合超声波治疗对高血压合并颈动脉斑块患者的影响

Clinical efficacy of ultrasound combined with atorvastatin in the treatment of carotid plaque patients with hypertension and different risk stratifications

目的探讨阿托伐他汀联合超声波治疗对高血压合并颈动脉斑块患者血脂、颈动脉斑块形态及预后的影响。方法选取2018年10月—2019年11月我院收治的125例高血压合并颈动脉斑块患者为研究对象,采用随机数字表法分为对照组(n=62)和观察组(n=63)。对照组在常规降压治疗基础上给予阿托伐他汀治疗,观察组在对照组基础上联合超声波治疗,两组均治疗3个月。比较两组患者治疗前后血脂水平、斑块状态、斑块性质及颈内动脉血流速度和颈动脉内膜中层厚度(IMT),并比较治疗后1年内脑血管病发生率。结果与治疗前比较,治疗后两组患者血清TC、TG水平均降低,且观察组低于对照组;两组血清HDL-C水平均升高,且观察组高于对照组(P<0.05)。与治疗前比较,治疗后两组患者斑块面积、斑块积分及IMT均减小,且观察组明显低于对照组;两组颈内动脉血流速度均增加,且观察组高于对照组(P<0.05)。与治疗前比较,治疗后观察组稳定斑块比例增加,不稳定斑块比例下降,且观察组消失斑块比例高于对照组(P<0.05)。治疗后1年内观察组脑血管病发生率低于对照组(P<0.05)。结论阿托伐他汀联合超声波治疗可更有效地改善高血压合并颈动脉斑块患者斑块形态,缩小斑块体积,也可有效降低血脂水平,改善患者预后。

Objective To investigate the influence of atorvastatin combined with ultrasound therapy on blood lipids,carotid plaque morphology and prognosis in patients with hypertension and carotid plaque.Methods 125 patients with hypertension and carotid plaque were divided into the control group(62 cases,treated with atorvastatin on the basis of conventional antihypertensive treatment)and observation group(63 cases,combined with ultrasound therapy on the basis of the control group)according to the random number table method,both groups were treated for 3 months.The blood lipid levels,plaque status,plaque properties,internal carotid artery blood flow velocity and carotid intima-media thickness(IMT)before and after treatment were compared between the two groups of patients,and the incidence of cerebrovascular disease within 1 year after treatment was compared.Results Compared with before treatment,the serum levels of TC and TG after treatment decreased in the two groups of patients,and the observation group was lower than the control group;the serum HDL-C levels of the two groups increased,and the observation group was higher than the control group(P<0.05).Compared with before treatment,the plaque area,plaque score and IMT after treatment decreased in the two groups of patients,and the observation group was significantly lower than the control group;the internal carotid artery blood flow velocity of the two groups increased,and the observation group was higher than the control group(P<0.05).Compared with before treatment,the proportion of stable plaques after treatment increased in the observation group,while the proportion of unstable plaques decreased,and the proportion of disappeared plaques in the observation group was higher than that of the control group(P<0.05).The incidence of cerebrovascular disease within 1 year after treatment in the observation group was lower than that in the control group(P<0.05).Conclusion Atorvastatin combined with ultrasound therapy can more effectively improve the plaque morphology of patients with hypertension and carotid plaque,reduce plaque volume,and can also effectively reduce blood lipid levels,improve the prognosis of patients.