PAS疗法对老年血脂紊乱合并颈动脉粥样硬化患者的疗效观察  

Therapeutic Effect of PAS Therapy on Carotid Atherosclerosis in Elderly Patients with Blood Lipid Disorders

作　　者：张涛[1] 周华东[1] 蒋晓江[1] 王延江[1] 许志强[1] 曹红元[1] 钟婷婷[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所神经内科,重庆400042

出　　处：《解放军医药杂志》2014年第3期60-64,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：重庆市重点课题(cstc2010AB5106)

摘　　要：目的观察联合应用阿司匹林、阿托伐他汀、普罗布考(PAS疗法)对于老年血脂紊乱患者颈动脉粥样硬化的疗效。方法选取2011年4月—2012年5月171例血脂紊乱合并颈动脉粥样硬化的老年患者,随机分为PAS组57例、AS组58例、A组56例进行比较研究。PAS组予普罗布考(0.5 g/d),阿司匹林(100 mg/d),阿托伐他汀钙(20 mg/d);AS组予阿司匹林(100 mg/d),阿托伐他汀钙(20 mg/d);A组予阿司匹林(100 mg/d)。结果 PAS组、AS组治疗后与本组治疗前及A组治疗后比较,总胆固醇(TC)、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白、白介素-6、肿瘤坏死因子(TNF)-α水平、颈动脉内膜中层厚度以及颈动脉斑块积分均显著改善(P<0.05,P<0.01)。治疗后PAS组TC、LDL-C、TNF-α水平与AS组差异均有统计学意义(P<0.01)。结论治疗血脂紊乱的老年颈动脉粥样硬化患者,他汀类药物结合抗血小板类药物通过调节血脂、抗炎,起到抗动脉粥样硬化的作用,加用普罗布考可以发挥更显著的疗效。Objective To observe the therapeutic effect of combined therapy of statins with probucol and aspirin （PAS therapy） on carotid atherosclerosis in elderly patients with blood lipid disorders. Methods A total of 171 elderly patients with carotid atherosclerosis complicated by blood lipid disorders during April 2011 and May 2012 were randomly divided into three groups. The PAS group （n = 57） was treated with Probucol （0.5 g/d） combined with Aspirin （100 mg/d） and Atorvastatin （20 mg/d） ; AS group （n = 58） was treated with Aspirin （100 mg/d） and Atorvastatin （ 20 mg/d） ; group A （ n = 56） underwent Aspirin （ 100 mg/d）. Results Levels of total cholesterol （ TC ）, triglyeerides （TG） ,low density lipoprotein cholesterol （LDL-C） , hypersensitivity C -reactive protein （hs-CRP） , interleukin-6 （IL- 6） and tumor necrosis faetor-c~ （TNF-oL） , intima-media thickness （IMT） and accumulated score of carotid plaque in PAS and AS groups after treatment were significantly improved, compared with those before treatment in the same group and after treatment in group A （P 〈 0. 05,P 〈 0. 01 ）. After treatment, the differences in levels of TC, LDL - C, TNF-c~ in PAS group showed statistical significances compared with those in AS group （P 〈 0.01 ）. Conclusion Statins com- bined with antiplatelet drugs has the effect of resistance to carotid arteriosclerosis by adjusting blood lipid and anti-inflam- matory reaction in elderly patients with blood lipid disorders complicated by carotid arteriosclerosis, and Probucol addition has better effect.

关 键 词：动脉粥样硬化 普罗布考 阿托伐他汀 阿司匹林 

分 类 号：R543.5[医药卫生—心血管疾病]