阿卡波糖早期改善合并2型糖尿病的急性冠脉综合征患者的颈动脉斑块回声

摘要

Objective To evaluated carotid artery plaque echolucency using ultrasound in patients with ACS and type 2 diabetes mellitus (T2DM) to determine whether acarbose may rapidly stabilize unstable atherosclerotic plaques.Methods ACS patients with T2DM and carotid plaques (n=132) were randomly assigned to treatment with acarbose (150 or 300 mg/d, n=66) or a control group (no acarbose, n=66). Acarbose treatment was initiated within 5 days after the onset of ACS. Unstable carotid plaques were assessed by measuring plaque echolucency using carotid ultrasound with integrated backscatter (IBS) before, and at 2 weeks, 1 month and 6 months after the initiation of treatment. An increase in the IBS value reflected an increase in carotid plaque echogenicity.Results IBS value of echolucent carotid plaques showed a significant increase at 1 month and a further increase at 6 months after treatment in the acarbose group, but there was minimal change in the control group. The increase in IBS values was significantly correlated with a decrease in C-reactive protein levels. Conclusion Acarbose rapidly improves carotid plaque echolucency within 1 month of therapy in patients with ACS and T2DM.%目的：对合并2型糖尿病(T2DM)的急性冠脉综合征(ACS)患者进行超声检查,评估颈动脉斑块回声增强,确定阿卡波糖是否可以迅速稳定不稳定的动脉斑块。方法连续性选入于2010年10月~2013年2月就诊于本院的合并T2DM的ACS患者且同时有颈动脉斑块的132例患者,将其随机分入阿卡波糖治疗组(150 or 300 mg/d, n=66)和对照组(n=66)。ACS患者于发病5 d内行阿卡波糖治疗。通过颈动脉超声以及整合背向散射技术测量斑块回声增强,评估不稳定的劲动脉斑块。治疗后2星期、1个月以及6个月内进行测量。整合背向散射指数(IBS)升高,说明颈动脉斑块回声增强。结果阿卡波糖治疗组, IBS在1个月内有显著升高,6个月内进一步升高,但对照组IBS只有少许变化。两组间差异有统计学意义(P<0.05)。同时, IBS增高与C反应蛋白水平下降密切相关。结论阿卡波糖可以改善合并T2DM的ACS患者的颈动脉斑块回声的增强。