超声造影检查对阿托伐他汀钙治疗颈动脉粥样硬化斑块的评价

摘要

Objective To evaluate the clinical effect of atorvastatin calcium on carotid atherosclerotic plaques with contrast-enhanced ultrasonography.Methods A total of 83 patients with carotid atherosclerotic plaques were randomly treated with conventional therapy alone(control group,n=30) or in combination with atorvastatin calcium tablets(treatment group,n=53).The plaque enhanced intensity(EI),carotid intima-media thickness(IMT),plaque length,plaque thickness,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C) and high density lipoprotein cholesterol(HDL-C) were measured before and after treatment for 6 and 12 months.Results In control group,carotid artery plaque EI,carotid IMT,plaque length and plaque thickness increased after treatment for 12 months(P<0.05).However,no changes in carotid artery plaque EI were observed in control group after treatment for 6 months(P>0.05).In treatment group,carotid artery plaque EI and serum TC,TG and LDL-C levels decreased but serum HDL-C levels increased after treatment for 6 and 12 months.Furthermore,carotid IMT,plaque length and plaque thickness reduced in treatment group after treatment for 12 months.Compared with control group,carotid artery plaque EI decreased after treatment for 6 and 12 months,carotid IMT,plaque length,plaque thickness and serum TC,TG and LDL-C levels reduced after treatment for 12 months,and serum HDL-C levels increased after treatment for 12 months in treatment group(P<0.05).In addition,carotid artery plaque EI measured after treatment for 6 months was not different from that measured after treatment for 12 months(P>0.05).Conclusion Atorvastatin calcium treatment can effectively reduce blood lipid levels and stabilize carotid atherosclerotic plaques.%目的 探讨超声造影检查评价阿托伐他汀钙治疗颈动脉粥样硬化斑块的临床疗效.方法 将83例颈动脉粥样硬化斑块形成患者按随机数字表法分为治疗组(53例)和对照组(30例).2组患者均给予常规治疗,在此基础上,治疗组患者加用阿托伐他汀钙片治疗.比较2组患者治疗前和治疗6、12个月后超声检查指标[颈动脉斑块增强强度(EI)、颈动脉内中膜厚度(IMT)、颈动脉斑块长径、颈动脉斑块厚度]和血脂[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]水平的变化.结果 与治疗前比较,对照组患者治疗6个月后颈动脉EI值无明显变化(P>0.05),治疗组患者治疗6、12个月后颈动脉EI值、血清TC、TG、LDL-C水平和治疗12个月后IMT、颈动脉斑块长径、颈动脉斑块厚度值均明显降低,对照组患者治疗12个月后颈动脉EI值及治疗组患者治疗6、12个月后血清HDL-C水平、对照组患者治疗12个月后IMT、颈动脉斑块长径、颈动脉斑块厚度值均明显升高(均P<0.05);与对照组比较,治疗组患者治疗6、12个月后颈动脉EI值和治疗12个月后IMT、颈动脉斑块长径、颈动脉斑块厚度值及血清TC、TG、LDL-C水平均下降更明显,血清HDL-C水平升高更明显(均P<0.05);与同组治疗6个月后比较,治疗组患者治疗12个月后颈动脉EI值无明显变化(P>0.05).结论 阿托伐他汀钙治疗颈动脉粥样硬化斑块能够有效降低患者的血脂水平,具有稳定颈动脉粥样硬化斑块的作用.