阿托伐他汀对人颈动脉硬化斑块的影响

摘要

Objective To evaluate the effect of atorvastatin on human carotid plaque by high resolution nuclear magnetic resonance imaging(MRI 3. 0T). Methods Forty patients with carotid artery plaque were treated with atorvastatin at the dose of 20 mg daily for one year. Changes of the artery plaques were observed by MRI,and the levels of blood lipoproteins and C reactive protein( hs-CRP)were detected. Results After the treatment with atorvastatin for 6 months and 1 year,the number and average thickness of plaques were reduced. One year after the treatment,average thickness of stable plaques dropped from (2. 41±0. 54)mm to(2. 17±0. 49)mm,and the size of the unstable plaques decreased from(2. 38±0. 89)mm to(2. 01± 0. 32)mm,with significant differences(P﹤0. 05). The levels of TC,TG,LDL-C and Hs-CRP were significantly decreased(P﹤0. 05)and the level of HDL-C was increased. Conclusion High resolution nuclear magnetic resonance( MRI3. 0T)can clearly display the components of the atherosclerotic plaque and the degree of artery stenosis. Atorvastatin exerts a significant effect on carotid plaque by promoting the regression of the carotid atherosclerosis plaque.%目的：利用高分辨率磁共振（ MRI3.0T）评价阿托伐他汀对人颈动脉硬化斑块的影响。方法对40例颈动脉硬化斑块患者给予阿托伐他汀治疗，治疗剂量为20 mg·d-1，连续服用1年。对治疗前后同一动脉硬化病变在高分辨MRI上的变化进行研究，同时对患者的血脂和高敏C反应蛋白（ hs-CRP）进行检测。结果患者服用阿托伐他汀6个月及1年后，颈动脉硬化斑块的数量及平均厚度均有降低。用药1年后，稳定斑块平均厚度由（2.41±0.54）mm下降为（2.17±0.49）mm，不稳定斑块平均厚度由（2.38±0.89）mm下降为（2.01±0.32）mm，与用药前相比差异有统计学意义（P﹤0.05）。患者总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、Hs-CRP 与用药前比较均显著降低（P﹤0.05），高密度脂蛋白胆固醇（ HDL-C）明显升高（ P﹤0.05）。结论采用高分辨率MRI可清晰显示颈动脉的斑块成分及狭窄程度。阿托伐他汀对动脉硬化不稳定斑块有良好的治疗效果，能够促进颈动脉硬化斑块的消退，可用于脑血管病的早期预防和治疗。