作者单位:550001贵阳医学院附属医院神经内科[胡晓(现在贵州省人民医院神经内科,550002)、楚兰、刘琦]通讯作者:楚兰,Emai:lchulan8999@sohu1com#临床研究#阿托伐他汀钙抗颈动脉粥样硬化及稳定斑块的作用胡晓楚兰刘琦摘要:目的探讨阿托伐他汀钙对脑血管病患者的抗动脉粥样硬化及稳定斑块的作用。方法选择缺血性脑血管病患者100例,均经颈动脉超声证实其颈动脉内有斑块形成。给予阿司匹林(商品名,拜阿司匹林)011g/d。在此基础上,分为阿托伐他汀钙组(治疗组)50例,服用阿托伐他汀钙20mg/d,持续6个月;对照组50例,未给予阿托伐他汀钙治疗。分别于治疗前、治疗后3和6个月检测血脂,用颈动脉超声检测患者的双侧颈动脉内-中膜厚度(IMT)、斑块形态等指标。结果¹治疗组服药3个月时,低密度脂蛋白胆固醇(LDL-C)和三酰甘油(TG)分别为(311?018)和(111?018)mmol/L,与对照组[(314?018)和(117?017)mmol/L]同时间点比较,差异有统计学意义(P<0105,P<0101);治疗组和对照组服药6个月时,总胆固醇(TC)为(413?019)、(516?018)mmol/L、LDL-L为(310?015)、(314?018)mmol/L、高密度脂蛋白胆固醇(HDL-C)为(111?012)、(110?013)mmol/L及TG为(111?019)、(116?013)mmol/L,两组同时间点比较,差异均有统计学意义(均P<0105)。º治疗组和对照组6个月时,IMT分别为110?014和111?012,Crouse斑块积分分别为110?016和111?015,两组比较,差异有统计学意义(均P<0105)。结论服用阿托伐他汀钙在短期内即可起到降脂作用,服药6个月以上可减轻缺血性脑血管病患者颈动脉粥样硬化程度,同时能够稳定斑块。关键词:颈动脉疾病;药物疗法;阿托伐他汀钙中图分类号:R74311文献标识码:AEffectsofatorvastatincalciumoncarotidatherosclerosisandthestabilityofplaquesHUXiao,CHULan,LIUQi.DepartmentofNeurology,GuizhouProvincialPeople'sHospital,Guiyang550002,ChinaCorrespondingauthor:CHULan,Email:chulan8999@sohu.comAbstract:ObjectiveToinvestigatetheeffectsofatorvastatincalciumoncarotidatherosclerosisandthestabilityofplaquesinpatientswithischemiccerebrovasculardisease.MethodsOnehundredpa-tientswithischemiccerebrovasculardiseasewereselected,andtheyweredividedintoatorvastatincalcium(20mg/d)group(treatmentgroup,n=50)andcontrolgroup(withoutatorvastatincalcium,n=50).Bloodlipidsweredetectedbefore,and3,6monthsafterthetreatment.Theintima-mediathickness(IMT)ofbilateralcarotidarteriesandplaquemorphologywereevaluatedwithcarotidultrasoundexamination.Results¹Lowdensitylipoproteincholesterol(LDL-C)andtriacylglycerol(TG)at3monthsinthetreatmentgroupwere3.1?0.8and1.1?0.8mmol/L,respectively.Ascomparedwiththecontrolgroup(314?0.8and1.7?0.7mmol/L)atthesametimepoint,thereweresignificantdifferences(P<0.05,P<0.01);Totalcholesterol(TC),LDL-L,highdensitylipoproteincholesterol(HDL-C)andTGat6monthsinthetreatmentgroupwere4.3?0.9,3.0?0.5,1.11?0.23and1.1?0.9,respectively.Ascomparedwiththecontrolgroupatthesametimepoint,thereweresignificantdifferences(P<0.05).ºTheITMinthetreatmentandcontrolgroupsat6monthwere1.0?0.4and1.1?0.2,respectively.Crouseintegralsinplaquewere1.0?0.6and1.1?0.5,respectively.Thereweresignificantdifferencesbetweenthe2groups(P<0.05).ConclusionAtorvastatincalciummayplayalipid-reducingeffectinashortterm,itcanreducetheseverityofcarotidatherosclerosisinpatientswithischemiccerebrovasculardisease,andstabilizetheplaquessimultaneously.#390#中国脑血管病杂志2008年9月18日第5卷第9期ChinJCerebrovascDis,Sep118,2008,Vol15,No19Keywords:Carotidarterydiseases;Drugtherapy;Atorvastatincalcium他汀类药物是近十几年研发的3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂。有研究发现,他汀类药物除具有调脂作用外,还能通过改善血管内皮细胞功能、抑制炎性反应、抑制平滑肌细胞的增生和促进凋亡、减少脂质在血管内皮层的沉积、减少泡...
