应用64层螺旋CT评价阿托伐他汀治疗效果的价值  

Effect of atorvastatin on computed tomography attenuation value of coro-nary plaques

作　　者：周逸[1] 陈曼华[1] 熊才金[1] 杨锴[1] 何琴[1] 陈刚[1] 

机构地区：[1]武汉市中心医院心血管内科,湖北武汉430014

出　　处：《心脏杂志》2015年第2期202-205,共4页Chinese Heart Journal

基　　金：武汉市卫生局临床医学科研项目资助(WX12B03)

摘　　要：目的:观察应用64层螺旋CT(64-SCT)评价阿托伐他汀治疗效果的价值。方法:回顾性分析阿托伐他汀治疗的36例患者,共计45处非钙化冠脉斑块病变。依据治疗后低密度脂蛋白胆固醇(LDL-C)水平分为达标组(17例,20处病变)和未达标组(19例,25处病变)。比较两组病例血生化指标的变化。比较两组病变血管重构系数、斑块体积、最小管腔直径、斑块平均CT值和最小CT值的变化。结果:达标组LDL-C降幅为47%,大于未达标组的30%(P<0.01)。两组的血管重构系数和斑块体积均可见减小的趋势,但差异均未达到统计学显著水平。与治疗前比较,达标组的斑块平均CT值增加了3.35 Hu(P<0.01),斑块最小CT值升高了10.95 Hu(P<0.01)。未达标组斑块平均CT值及最小CT值均与基线时相似。结论:阿托伐他汀治疗(LDL-C达标)有利于提高冠脉斑块的稳定性。AIM： To observe the effect of atorvastatin therapy on computed tomography（ CT） attenuation value of non-calcified coronary plaques. METHODS： Thirty-six patients with 45 plaques without calcification were analyzed retrospectively. The patients were divided into target-achieving group（ 17 patients and 20 plaques） and non-target-achieving group（ 19 patients and 25 plaques） according to the level of low-density lipoprotein cholesterol at follow-up. Changes in serum lipid profile and CT parameters from baseline to follow-up between groups were compared. RESULTS： Reduction of low-density lipoprotein cholesterol in achieving target group and failing to achieve target group were 47% and 30%,respectively.Low-density lipoprotein cholesterol in target-achieving group was significantly lower than that in nontarget-achieving group（ P〈0. 01）. No significant difference was observed in the changes of remodeling index and plaque volume from baseline to follow-up in both groups. Mean CT attenuation value and minimum CT attenuation value of the coronary plaque increased respectively 3. 35 Hu and 10. 95 Hu from baseline to follow-up in target-achieving group（ P〈0. 01）. Changes of mean CT attenuation value and minimum CT attenuation value of plaques from baseline to follow-up were not significantly different in non-target-achieving group. CONCLUSION： Increase of mean CT attenuation value and minimum CT attenuation value of plaques from baseline to follow-up in target-achieving group may indicate coronary plaque stabilization. Insignificant changes between baseline and follow-up in non-target-achieving group suggest the importance of achieving the therapeutic target of low-density lipoprotein cholesterol.

关 键 词：他汀 冠状动脉 斑块 体层摄影术 螺旋计算机 

分 类 号：R445.3[医药卫生—影像医学与核医学]