瑞舒伐他汀钙联合硫酸氢氯吡格雷对高脂血症患者颈动脉内膜中层厚度的影响

摘要

目的：探讨瑞舒伐他汀钙联合硫酸氢氯吡格雷对中老年高脂血症患者血脂、肿瘤坏死因子（ TNF-α）、白介素-1（IL-1）、白介素-6（IL-6）水平及颈动脉内膜中层厚度（IMT）、斑块面积的影响。方法将134例高脂血症患者随机分为观察组70例，给予瑞舒伐他汀钙10 mg、硫酸氢氯吡格雷75 mg口服，每天1次；对照组64例，仅给予硫酸氢氯吡格雷75 mg口服，每天1次。治疗前、治疗12周后，分别测定2组患者胆固醇（ TC）、三酰甘油（ TG）、高密度脂蛋白胆固醇（ HDL-C）、低密度脂蛋白胆固醇（ LDL-C），血清TNF-α、IL-1、IL-6水平及IMT、斑块面积。结果治疗前2组患者TC、TG、LDL-C、HDL-C、TNF-α、IL-1、IL-6、IMT、斑块面积比较，差异均无统计学意义（ P ＞0．05）。与治疗前比较，治疗12周后对照组TG、TC、TNF-α、IL-1、IL-6均下降（ P ＜0．05），而LDL-C、HDL-C、IMT及斑块面积均无明显变化（ P ＞0．05）；观察组TG、TC、LDL-C、TNF-α、IL-1、IL-6均下降，IMT及斑块面积均缩小，HDL-C升高（ P ＜0．05）。治疗12周后与对照组比较，观察组TG、TC、LDL-C及TNF-α、IL-1、IL-6水平明显降低（ P ＜0．05），HDL-C水平明显升高（ P ＜0．05），IMT、斑块面积显著减小（ P ＜0．05）。结论瑞舒伐他汀钙联合硫酸氢氯吡格雷能明显降低高脂血症患者血脂及炎性因子水平，减小颈动脉内膜中层厚度和斑块面积。%Objective To observe the effect of rosuvastatin calcium combined with clopidogrel on blood lipid , serum tumor necrosis factor-α(TNF-α), interleukin-1 (IL-1), interleukin-6 (IL-6) level and carotid artery intima-media thickness (IMT),as well as the effect on plaque area ,in elderly patients with hyperlipidemia .Methods 134 patients with hyperlipi-demia were randomly divided into the observation group of 70 cases, with rosuvastatin calcium 10 mg, clopidogrel hydrogen sulfate 75 mg orally, 1 times a day;64 patients in control group only received clopidogrel hydrogen sulfate , 75 mg orally, 1 times a day.Before treatment, after 12 weeks of treatment, 2 groups of patients'total cholesterol (TC) were measured,total triglyceride ( TG) , high density lipoprotein cholesterol ( HDL-C) , low density lipoprotein cholesterol ( LDL-C) , serum TNF-α, IL-1, IL-6 and IMT, plaque area were measured and recorded .Results Before treatment, there were no significant differ-ences of 2 groups'TC, TG, HDL-C, LDL-C, TNF-α, IL-1, IL-6, IMT, plaque area, ( P >0.05).Compared with those be-fore treatment, 12 weeks after the treatment, control group's TG, TC, TNF-α, IL-1,IL-6 were decreased ( P <0.05), and LDL-C, HDL-C, IMT and plaque area had no significant changes ( P >0.05);observation group's TG, TC, LDL-C, TNF-α, IL-1, IL-6 were decreased, IMT and plaque area were reduced, HDL-C increased ( P <0.05).After 12 weeks of treat-ment, compared with the control group , the observation group's TG, TC, LDL-C and TNF-α, IL-1, IL-6 levels were signifi-cantly lower ( P <0.05), HDL-C levels were significantly elevated ( P <0.05), IMT, plaque area was significantly re-duced ( P <0.05).Conclusion Rosuvastatin calcium combined with clopidogrel hydrogen sulfate could significantly de -crease the blood lipid and inflammatory factor level in patients with hyperlipidemia ,reduce the carotid intima-media thickness and plaque area .