阿托伐他汀钙治疗不同回声颈动脉斑块的临床观察(1)
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[摘要] 目的 观察阿托伐他汀钙对不同回声颈动脉斑块的治疗效果。 方法 选取经过超声检查发现的117个斑块，给予患者阿托伐他汀钙20mg qN治疗6个月，测量治疗前、治疗6个月后斑块的厚度及回声。结果 低回声、不均回声斑块两次测量斑块厚度有明显变化，差异有统计学意义，部分斑块回声发生变化；等回声斑块及强回声两次测量斑块厚度变化差异无统计学意义，斑块回声未发生变化。结论 他汀类药物治疗不同回声颈动脉斑块的效果不尽相同，对低回声、不均回声斑块的作用优于等回声、强回声斑块。
[关键词] 阿托伐他汀钙；颈动脉；斑块；超声
[中图分类号] R743.3 [文献标识码] B [文章编号] 1673-9701(2011)36-143-02
The Clinical Observation of Atorvastatin on Carotid Artery Plaques of Different Echo
HE Yan LU Jiancong CHEN Huiling CUI Suijing
Department of Neurology，Huizhou Municipal Central Hospital，Huizhou 516001，China
[Abstract] Objective To observe the effect of atorvastatin calcium on carotid artery plaques of different echo. Methods A total of 117 carotid artery plaques were found by ultrasound. All the patients were treated with atorvastatin calcium(20mg)per night for 6 months. The thickness and echo of the carotid artery plaques were evaluated at the beginning of the study and 6 months after treatment. Results Both low echo plaques and inhomogeneous echo plaques had sinificant differences in thickness between the evaluation at the beginning of the study and 6 months after treatment，and some of the plaques changed in echo. Both middle echo plaques and high echo plaques had no sinificant difference in thickness and echo between the evaluation at the beginning of the study and 6 months after treatment. Conclusion The study suggests that atorvastatins have different effects on carotid artery plaques of different echo. The effects on low and inhomogeneous echo plaques are superior to that on the middle and high echo plaques.
[Key words] Atorvastatin calcium；Carotid artery；Plaque；Ultrasound
动脉粥样硬化是最常见的全身性动脉疾病，以脂质和胶原成分的累积为主要特征，随着斑块的发展，可继发钙化、斑块内出血、斑块表面溃疡及血栓形成、斑块内新生血管形成、血管中膜平滑肌萎缩导致的弹性下降。由于颈动脉是人体较大的浅表动脉，可被超声仪器探测到，高分辨率的超声检查提供了一种可定量评估颈动脉粥样硬化进展的非侵入性检查方法，这种方法被证明有高度可重复性，因此颈动脉超声检测可作为观察全身动脉硬化进展和消长的指针[1]。2003年美国心脏学会(AHA)年会上公布了强化降脂逆转动脉粥样硬化进展的结果，提示他汀类药物可阻止或逆转动脉粥样硬化的发展[2]。本研究通过颈动脉超声检测观察阿托伐他汀钙对不同回声颈动脉斑块的治疗效果。
1 资料与方法
1.1 一般资料
选取2009年8月～2010年12月初次就诊的经颈动脉超声发现的来自59例患者的117个斑块，根据斑块回声分成四组，分别为低回声斑块组(23个)、等回声斑块组(41个)、强回声斑块组(14个)和不均回声斑块组(39个)。患者年龄43～74岁，其中男41例，女18例。59例患者中，糖尿病17例，高血压23例，冠心病10例，脑梗死38例，有吸烟史者31例。患者初诊经实验室检查均未发现肝功能异常，其中47例有高胆固醇和/或高甘油三酯血症、高LDL血症 ......
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