目的：系统评价中国动脉粥样硬化患者在常规治疗基础上加用阿托伐他汀后抗动脉粥样硬化治疗的疗效。方法采用计算机检索PubMed、EMBASE、CENTRAL、CBMDisc、CMCI、CNKI、VIP、Wanfang数据库中阿托伐他汀抗动脉粥样硬化的疗效的随机与半随机临床试验，两名评价者独立进行文献质量评价、提取资料并进行核对，运用Review manager 5.2.1软件分析均数差及95%可信区间。结果符合纳入标准文献共27篇，干预组总人数为1558人，对照组为1495人。Meta分析结果显示：与对照组比较，干预组使用阿托伐他汀10 mg/d治疗24周颈动脉内膜中膜厚度（IMT）值降低0.15 mm （95%CI：-0.30～-0.01），治疗96周IMT降低0.81 mm（95%CI：-1.11～-0.51）；阿托伐他汀20 mg/d治疗12周能使颈动脉IMT值降低0.10 mm（95%CI：-0.18～-0.03），治疗24周颈动脉IMT值降低0.36 mm （95%CI：-0.49～-0.23），治疗48周颈动脉IMT值降低0.22 mm（95%CI：-0.31～-0.13）。结论阿托伐他汀有效降低颈动脉内膜中层的厚度，减缓动脉粥样硬化的进展。%Objective To review systematically the curative effect of atorvastatin on atherosclerosis in patients with atherosclerosis treated with atorvastatin besides of routine treatment in China. Methods The databases of PubMed, EMBASE, CENTRAL, CBMDisc, CMCI, CNKI, VIP and WanFang were retrieved with computer for collecting the randomized or semi-randomized clinical trials about the curative effect of atorvastatin on atherosclerosis, and then 2 reviewers independently reviewed trial quality, extract material and checked data. The software of Review manager 5.2.1 was used for analyzing mean difference (MD) and 95%confidence interval (CI). Results There were totally 27 trials included involving 1558 cases in intervention group and 1495 cases in control group. The Meta-analysis showed that carotid artery intima-media thickness (CA-IMT) was reduced by 0.15 mm (95%CI:-0.30--0.01) after treatment with atorvastatin (10 mg/d) for 24 w, and by 0.81 mm (95%CI:-1.11--0.51) after 96 w in intervention group compared with control group. CA-IMT was reduced by 0.10 mm (95%CI:-0.18--0.03) after treatment with atorvastatin (20 mg/d) for 12 w, by 0.36 mm (95%CI:-0.49--0.23) after 24 w, and by 0.22 mm (95%CI:-0.31--0.13) after 48 w in intervention group compared with control group. Conclusion Atorvastatin can effectively reduce CA-IMT and delay the development of atherosclerosis.
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