小剂量阿托伐他汀钙对颈动脉斑块患者血清P-选择素及血脂影响

摘要

Objective To observe the long-term effect of low-dose Atorvastatin calcium on P-selectin and lipids levels in blood serum of the patients with carotid artery plaque. Methods 79 patients with carotid artery plaque were randomly divided into treatment group(n =43) and control group(n =36), and 30 controls without carotid artery plaque were enrolled as non-plaque group. The treatment group received oral Atorvastatin calcium and enteric coated aspirin. The control group only received enteric coated aspirin treatment. Before treatment and 6, 18 months after treatment, P-selectin and blood lipids levels were assayed respectively, meanwhile, primary end point and adverse reaction were recorded. Non-plaque group did not undergo interventions, only leaving the blood for P-selectin and blood lipids detection. Results There was no significant difference in incidence rate of primary end point events between the treatment group and control group(P >0.05). P-selectin level in non-plaque group was lower than that in the plaque group (P 0.05). In the 6th and 18th month, the blood cholesterol, low-density lipoprotein levels in the treatment group were significantly lower when compared with those before treatment, and the differences were significant(P 0. 05). At different time points, there were significant differences of blood lipid indicators between treatment group and control group( P <0. 05 ,P <0. 01). There were no serious side effects in treatment group. Conclusion Low-dose atorvastatin calcium can not only regulate the blood lipids, but also by inhibiting inflammatory mediators P-selectin inhibit the inflammatory response, anti-platelet and prevent the occurrence of ischemic cerebrovascular disease.%目的 观察小剂量阿托伐他汀钙对颈动脉斑块患者血清P-选择素及血脂的长期影响.方法 选取有颈动脉斑的79例作为斑块组,随机分为斑块治疗组43例及斑块对照组36例；另选无颈动脉斑块30例作为无斑块组.斑块治疗组予阿托伐他汀钙、肠溶阿司匹林口服；斑块对照组仅予肠溶阿司匹林口服.观察治疗前和治疗后6个月、18个月P-选择素及血脂水平的变化,并记录两组终点事件及不良反应情况.无斑块组不予干预,仅留血用于P-选择素及血脂的对照研究.结果 斑块治疗组和斑块对照组终点事件发生率差异无统计学意义(P＞0.05).无斑块组P-选择素水平明显低于斑块组,差异有统计学意义(P＜0.05).治疗组6个月和18个月P-选择素水平与治疗前比较明显降低,差异有统计学意义(P＜0.05).对照组P-选择素水平在18个月观察期内差异均无统计学意义(P＞0.05).治疗组6、18个月时血胆固醇、低密度脂蛋白水平明显降低,与治疗前比较差异有统计学意义(P＜0.01),18个月甘油三酯水平降低,高密度脂蛋白升高,与治疗前比较差异有统计学意义(P＜0.05).对照组血脂各项指标在18个月观察期内差异均无统计学意义(P＞0.05).治疗组与对照组不同时间点血脂水平比较差异均有统计学意义(P ＜0.05,P＜0.01).治疗组无严重不良反应.结论 小剂量阿托伐他汀钙在调脂的同时,还可通过抑制炎症介质P-选择素抑制炎性反应,稳定斑块,从而预防缺血性脑血管病的发生.