应用超声评估阿托伐他汀对颈动脉粥样硬化性狭窄病变的影响  

Impact of atorvastain on carotid atherosclerotic stenosis assessed with ultrasound

作　　者：华扬[1] 焦志欣 贾凌云[1] 段春[1] 凌晨[1] 

机构地区：[1]首都医科大学宣武医院血管超声科,北京100053 [2]北京海淀医院超声科

出　　处：《中国脑血管病杂志》2013年第11期583-587,共5页Chinese Journal of Cerebrovascular Diseases

基　　金：首都卫生发展科研专项资助项目(首发2011-2001-02)

摘　　要：目的应用彩色多普勒血流显像（CDFI）评估阿托伐他汀对颈动脉粥样硬化性狭窄病变进程的影响。方法纳入2007年1月-2010年12月在首都医科大学宣武医院血管超声科行颈动脉超声检测，首诊为一侧颈动脉粥样硬化性中度（狭窄率50％～69％）狭窄者52例。所有患者每6个月检测1次，至少连续观察2．5年。根据是否规律服用阿托伐他汀钙（20mg/每晚），将患者分为规律服药组（A组，21例）和非规律服药组（B组，31例），分别于0．5、1．0、1．5、2．0、2．5年比较两组颈总动脉内一中膜厚度（CCA-IMT）、狭窄处责任斑块厚度（RPT）变化的差异。结果①与初检时比较，两组IMT均有随时间延长而逐渐增厚的趋势，差异有统计学意义。其中A组2．5年IMT平均增长0．062inln，B组平均增长0．113mm。与前一阶段比较，A组IMT增厚值在2年后开始出现下降趋势，B组无下降趋势。2．5年时两组IMT值差异有统计学意义。②两组RPT值均有逐渐增厚的趋势。与初检时比较，A组各阶段RPT增厚值差异均无统计学意义。B组各阶段RPT增厚值除与初检时差异均有统计学意义外，与前一阶段比较，差异亦有统计学意义（1．0与1．5年，1．5与2．0年阶段除外），P〈0．05或P〈0．01。2．5年A组RPT共平均增厚0．560mm。B组平均增厚0．955mm。③以CCA-IMT变化〉0．1mm，RPT变化〉0．3mm定义CCA-IMT及RPT为增厚。2．5年时B组患者RPT增厚的发生率明显高于A组[分别为87．1％（27/31）与57．1％（12/21）]，差异有统计学意义，P〈0．05。结论规律、长期应用阿托伐他汀钙可以减缓颈动脉粥样硬化性狭窄患者CCA-IMT、RPT的进程。Objective To assess the impact of atorvastatin on carotid atherosclerotic stenosis with color Doppler flow imaging （CDFI）. Methods A total of 52 patients who were first diagnosed as moderate unilateral carotid atherosclerotic stenosis （stenosis rate, 50-69% ） at the Department of Vascular Ultrasound, Beijing Xuanwu Hospital, Capital Medical University from January 2007 to December 2010 were enrolled in this study. All the patients were examined once every 6 months and were continuously observed for at least 2.5 years. According to whether taking atorvastatin regularly or not （20 mg/night）, the patients were divided into either regular medication group （group A, n = 21 ） or irregular medication group （group B, n = 31 ）. The differences in changes of intimal medial thickness common carotid artery （CCA-IMT）, responsible plaque thickness （RI~） of stenosis were compared between the two groups. Results @ Compared to the first examination, the IMT in both groups had a tendency of gradually thickening with the significant difference. IMT increased 0. 062 mm in 2.5 years in group A and 0.113 mm in group B. Compared to the earlier stage, the increased IMT value in group A had a tendency of decreasing after two years, while group B remained increasing rate. There was significant difference forincreased IMT at 2.5 years between the two groups. （~）The RPT values in both groups had a tendency of gradually thickening. Compared to the first examination, there was no significant difference in the RPT thickening values at each stage in group A. In group B, the RPT thickening value at each stage had significant difference compared with the value at the first examination, and also between later stage and ear lier stage（ except 1.0 years vs. 1.5 years, 1.5 years vs. 2.0 years） （P 〈 0.05 or P 〈 0.01 ）. At 2.5 year, RPT in group A increased 0. 560 mm and in group B increased 0. 955 ram. ③The changes of CCA-IMT 〉 0.1 mm and RPT 〉 0.3 mm were defined as th!ckening . And the rate of RPT th

关 键 词：颈动脉狭窄 动脉粥样硬化 超声检查 多普勒 彩色 阿托伐他汀 

分 类 号：R743.3[医药卫生—神经病学与精神病学]