颈动脉斑块稳定性与血清超敏C-反应蛋白的相关性及卡维地洛干预研究  

Correlation of stability of carotid atherosclerotic plaques and hypersensitive C-reaction protein and the effects of carvedilol

作　　者：叶炳华[1] 管耘园[2] 卢辉和[2] 吴红萍[3] 盛臻强[2] 

机构地区：[1]泰州市高港人民医院心内科,江苏省225321 [2]南通市第一人民医院心内科 [3]南通市第一人民医院心超室

出　　处：《中国心血管病研究》2011年第8期572-575,共4页Chinese Journal of Cardiovascular Research

基　　金：江苏省卫生厅医学招标项目（H200768）

摘　　要：目的观察颈动脉粥样斑块稳定性与血清超敏C－反应蛋白（hsCRP）的相关性及卡维地洛干预对斑块稳定性的影响。方法90例高血压伴颈动脉粥样易损斑块（VP）的患者随机分为两组各45例，分别给予卡维地洛（CAR）或美托洛尔（MET）治疗6个月。治疗前、后分别测定血脂、血糖、血清hsCRP，并通过彩色超声检查观察患者颈动脉斑块声学密度定量（AD）值及VP数量的变化。结果两组斑块AD值较治疗前均有增加，但以CAR组更显著（t=5．8517，P〈0．01）；治疗后CAR组与MET组VP数量分别减少19个和9个（χ2=4．1745，P〈0．05）；两组血清hsCRP较治疗前均明显降低，以CAR组更显著（t=7．6481，P〈0．01）；治疗前后血糖、心牢、血压变化两组问比较差异均无统计学意义；斑块AD值与hsCRP呈负相关（r=－0．6934，P〈0．01）。结论CAR比MET有更强的稳定斑块作用，其机制可能在于CAR除B受体阻断作用外还具有更强的抗炎作用。Objective To investigate the correlation of stability of carotid atherosclerotic plaques, serum hypersensitive C-reaction protein （hsCRP） and the effects of carvedilol. Methods 90 hypertensive patients with carotid atherosclerotic vulnerable plaques（VP） were divided randomly into two groups with 45 for each which were treated with earvedilol or metoprolol respectively for 6months. Serum lipid, blood glueose and hsCRP were mea- sured before and after treatment, the value of acoustic density（AD value ） of earotid atheroselerotie plaques and the number of VP were detected with the color Doppler ultrasonography. Results After treatment, the AD value of plaques in two groups were all inereased, but the change eould be observed signifieantly in earvedilol group （t= 5.8517,P〈0.01 ）,and the decreased number of VP in carvedilol group was signifieantly different from it in metoprolol group χ2=4.1745, P〈0.05 ）. Carvedilol eould reduee the level of serum hsCRP more than metoprolol （t =7.6481 ,P〈0.01 ）. The changes of Blood glucose, heart rate and blood pressure before and after treatment in two groups were no significantly difference （P〉0.05）. There were signifieant negative correlations between AD value of plaques and serum hsCRP （r=-0.6934,P〈0.01）. Conclusion Both carvedilol and metoprolol can improve the stability of the plaque, but carvedilol is more superior. Its mechanisms may lie in that carvedilol still has function of more superior anti-inflammatory effect than metoprolol in addition to its function of blocking β-receptor.

关 键 词：动脉粥样硬化 卡维地洛 声学密度定量技术 C反应蛋白质 

分 类 号：R541.4[医药卫生—心血管疾病]