瑞舒伐他汀对颈动脉粥样硬化患者颈动脉内中膜厚度及血清炎症因子的影响

摘要

Objective:To explore the effect of rosuvastatin on serum lipids, inflammatory factors and carotid intima-media thickness (IMT) in patients with carotid atherosclerosis and to observe the time points cf clinical significance for rosuvastatin treatment Methods:Our study included two groups,Treatment group,81 patients with carotid atherosclerosis were randomly selected with oral rosuvastatin 10mg/d for 6 months,and Control group,52 subjects with normal carotid artery were enrolled at the same period of time and all participants had low-fat diet Carotid IMT, serum lipids, high-sensitivity C-reactive protein (hs-CRP) and matrix metalloproteinase-9( MMP-9)were detected at the base line and monthly after the treatment respectively. Results:①Before the treatment,the serum levels of TC,TG,LDL-C,hs-CRP,MMP-9 and carotid IMT were higher in Treatment group than those in Control group,while HDL-C was lower in Treatment group,P＜0. 05 respectively. ②In Treatment group, the serum levels of TC,TG,LDL-C,hs-CRP,MMP-9 and carotid IMT were decreased after 6 months of medication than those were before,P＜0. 05 respectively,and HDL-C was increased than it was before,P＜0. 01. ③The time points of clinical significance for rosuvastatin in Treatment group as folIows:TC,LDL,hsCRP and MMP-9 were decreased after 1 month treatment,TG decreased after 2 months,the HIL was increased after 3 months,and carotid IMT was obviously lower after 6 months of medication,P＜0. 05 respectively. Conclusion:Rosuvastatin could effectively decrease the serum lipids, it has the role of anti-inflammation and anti-carotid atherosclerosis. Carotid IMT could be decreased after 6 months of rosuvastatin medication in patients with carotid atherosclerosis.%目的:观察瑞舒伐他汀对颈动脉粥样硬化患者颈动脉内中膜厚度(IMT)及血清炎症因子的影响,并了解瑞舒伐他汀出现临床治疗效果的时间点.方法:同期随机入选颈动脉粥样硬化患者81例为治疗组(口服瑞舒伐他汀10 mg/d),颈动脉内膜正常者52例为对照组,所有入选者低脂肪饮食.治疗前和治疗后6个月每月末检测血清低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、高敏C反应蛋白(hsCRP)及基质金属蛋白酶-9(MMP-9)浓度,并经超声检测颈动脉IMT.结果:治疗前治疗组血清TC、TG、LDL-C、hsCRP和MMP-9浓度及颈动脉IMT均高于对照组(P＜0.05～0.01),HDL-C低于对照组(P＜0.05),差异均有统计学意义.与治疗前比较,治疗组各观察指标从开始出现显著差异的时间点:从治疗后1个月开始血清TC、LDL-C、hsCRP及MMP-9明显下降,从2个月开始TG明显下降,从6个月开始颈动脉IMT明显降低,至6个月末均明显下降(P＜0.05～0.01);从3个月开始HDL-C明显升高,至6个月末均明显升高(P＜0.05～0.01),差异均有统计学意义.结论:瑞舒伐他汀具有良好的调脂、抗炎和抗颈动脉粥样硬化作用,治疗6个月后颈动脉IMT明显降低.