辛伐他汀对代谢综合征患者颈动脉结构和功能的影响  

Investigation on the intervention effects of Simvastatin on the structure and function of carotid artery in patients with metabolism syndrome

作　　者：胡兆霆[1] 赵素玲[2] 梁燕琼[1] 侯庆臻[1] 丁亚楠[1] 陈毅华[1] 卓茹[1] 

机构地区：[1]南方医科大学第三附属医院心内科,广州510630 [2]南方医科大学第三附属医院超声科

出　　处：《临床心血管病杂志》2011年第6期449-451,共3页Journal of Clinical Cardiology

基　　金：广东省医学科学技术研究基金(No:A2008391)

摘　　要：目的:通过超声检测颈动脉的结构和功能,观察辛伐他汀对代谢综合征患者颈动脉结构和功能的作用。方法:选择85例代谢综合征患者,检测体质指数(BMI)、腰围、血脂、空腹血糖、血浆超敏C反应蛋白(hs-CRP)和颈动脉超声测量颈动脉内膜-中层厚度(IMT),计算斑块指数、颈动脉顺应性、颈动脉扩张性及颈动脉僵硬度。比较辛伐他汀治疗4周、24周及48周后各指标及颈动脉超声参数的改变。结果:治疗4周后,代谢综合征患者血浆LDL-C、hs-CRP水平下降;颈动脉顺应性、颈动脉扩张性及颈动脉僵硬度已有明显改善,但颈总动脉IMT、斑块指数无明显变化。治疗24周后,颈动脉顺应性、颈动脉扩张性及颈动脉僵硬度进一步改善;血浆LDL-C、hs-CRP水平进一步下降;颈总动脉IMT、斑块指数有明显改善。治疗48周后,血浆LDL-C、hs-CRP水平与治疗24周相比,无进一步下降,但颈总动脉IMT、斑块指数仍能进一步改善。结论:代谢综合征患者使用辛伐他汀短期能有效改善颈动脉的功能,长期治疗有消退颈动脉斑块的作用,其作用机制可能与其抗炎作用有关。Objective：To measure the structure and function of carotid artery,and furtherly to investigate the effects of simvastatin on the carotid artery.Method：After selecting 85 patients with metabolism syndrome（MS）,their body mass indexes,waist circumferences,blood lipids,fasting blood glucose,plasma hs-CRP were measured.The intima-media thickness（IMT） of the common carotid artery,the plaque index,the compliance of carotid artery,the distensibility of common carotid artery,carotid artery stiffness,wall surface and wall texture were examined using B-mode ultrasonography.All the parameters were meatured again after the patients were treated with sinvastatin for 4,24,and 48 weeks respectively,and were compared with the original parameters.Result：After treatment with simvastatin for 4 weeks,the plasma levels of LDL-C and hs-CRP decreased,and the compliance of carotid artery,the distensibility of common carotid artery and the carotid artery stiffness were improved significantly.But the IMT and the plaque index were not changed markedly.After treatment with simvastatin for 24 weeks,the plasma levels of LDL-C and hs-CRP decreased more significantly,and further imporvement was seen on the compliance of carotid artery,the distensibility of common carotid artery and the carotid artery stiffness.Among the improvements,the most important thing is that the IMT and plaque index were also improved.After treatment with simvastatin for 48 weeks,the changes on the plasma levels of LDL-C and hs-CRP were not apparent,but the IMT and plaque index could be further improved.Conclusion：Simvastatin can be used safely in patients with MS as a short,media or long-term treatment.The short-term treatment with simvastatin can improve the function of the carotid artery in patients with MS.The media and long-term treatment with simvastatin can also improve the structure of the carotid artery.But the underlying mechanisms need further investigation.

关 键 词：动脉粥样硬化 代谢综合征 辛伐他汀 

分 类 号：R543[医药卫生—心血管疾病]