Objective To study the influences of rosuvastatin on lipid level and thickness of plaque in patients with carotid atherosclerosis and to observe its long - term effects on atherosclerosis. Methods 40 patients diagnosed by Color Doppler ultrasound with carotid artery plaque from clinics and medical centers from January 2008 to December 2009 were randomly divided into treatment group and control group, with each group 20 cases. The treatment group was given rosuvastatin 10 mg/d combined with enteric - coated aspirin 75 mg/d. The control group was only given enteric - coated aspirin 75 mg/d. Patients of the two groups were given drugs accordingly to decrease blood pressure and glucose and were given diet controls. Lipid levels, total numbers of carotid artery plaque, plaque thickness and plaque changes of the two groups were observed before treatment and 12 months after treatment, and end points of the two groups were also recorded. Results ( 1 ) In the treatment group, serum TC level was reduced significantly from ( 4. 93 ± 1. 12 ) mmol /L to ( 3. 80 ±0. 98 ) mmol/L, LDL - C level was reduced significantly from ( 3. 80 ± 1. 73 ) mmol/L to ( 2. 38 ± 1. 18 ) mmol/L ( P < 0. 05 ) . HDL - C level and TG level showed no significant change compared with those before the treatment ( P > 0. 05 ) . Indexes of blood lipid in the control group showed no significant change during observing period. ( 2 ) Total numbers of plaques showed no significant change in the treatment group after treatment, while the plaque thickness reduced significantly from ( 1. 92 ± 0. 53 ) mm to ( 1. 10 ± 0. 50 ) mm ( P < 0. 05 ), and 74. 5 % of soft plaques changed into hard plaques. Total numbers of plaques showed no significant change in the control group, while the plaque thickness increased from ( 1. 60 ±0. 37 ) mm to ( 1. 72 ±0. 38 ) mm, and 15. 7% of soft plaques changed into hard plaques. Conclusion ( 1 ) The lipid lowering drug rosuvastatin can reduce TC and LDL levels in hyperlipidemia patients with carotid atherosclerosis. ( 2 ) Rosuvastatin can reduce plaque thickness of hyperlipidemia patients with carotid artery atherosclerotic , and can stabilize plaque in carotid artery.%目的 探讨颈动脉粥样硬化患者应用瑞舒伐他汀药物治疗对血脂水平及颈动脉粥样硬化斑块厚度及稳定性的影响.方法 选择我院2008年1月-2009年12月门诊及体检中心,经颈动脉彩色超声证实有颈动脉斑块,自愿参加临床观察的40例患者作为观察对象,随机分为治疗组和对照组,各20例.治疗组给予瑞舒伐他汀10 mg/d,合并应用肠溶阿司匹林75 mg/d,对照组给予肠溶阿司匹林75 mg/d.并根据病情给予降压、降糖等药物,两组均进行饮食控制.观察治疗前、治疗后12个月两组血脂水平及颈动脉斑块总数、斑块厚度及斑块性质的变化,并记录两组终点事件的发生情况.结果 (1)治疗组服用瑞舒伐他汀12个月后,血清总胆固醇(TC)水平由(4.93±1.12)mmol/L降至(3.80±0.98)mmol/L,低密度脂蛋白胆固醇(LDL-C)水平由(3.80±1.73)mmol/L降为(2.38±1.18)mmol/L(P＜0.05);高密度脂蛋白胆固醇(HDL-C)和三酰甘油(TG)水平与用药前比较,差异无统计学意义(P＞0.05).对照组观察期内各项血脂指标无明显变化(P＞0.05).(2)治疗组患者治疗前后斑块数未见明显变化,斑块的厚度由治疗前的(1.92±0.53)mm降为(1.10±0.50)mm(P＜0.05),74.5%软斑块转为硬斑块.对照组患者治疗前后斑块数未见明显变化,斑块的厚度由治疗前(1.60±0.37)mm上升为(1.72±0.38)mm,15.7%软斑块转变为回声较强的硬斑块.结论 (1)调脂药物瑞舒伐他汀能够降低高脂血症颈动脉粥样硬化患者血清中TC及LDL-C水平.(2)瑞舒伐他汀能够促使高脂血症颈动脉粥样硬化患者斑块厚度减低,具有促进颈动脉软斑块趋于稳定的作用.
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