瑞舒伐他汀强化降脂治疗对冠状动脉弥漫性长病变斑块结构的影响  

Effects of Rosuvastatin Intensive Lipid Lowering Terapy on Plaque Composition of Coronary Artery with Diffuse and Long Lesions

作　　者：官兵[1] 韦旭斌[1] 林志[1] 杨帆[1] 孙林[1] 

机构地区：[1]昆明医科大学第二附属医院心血管内科,650101

出　　处：《中国老年保健医学》2016年第1期14-16,共3页Chinese Journal of Geriatric Care

基　　金：云南省教育厅科学研究基金(2015Z080)

摘　　要：目的探讨瑞舒伐他汀钙强化降脂治疗对冠状动脉弥漫性长病变斑块组分及结构的影响。方法选择冠状动脉造影（CAG）血管直径狭窄50%~70%,病变长度超过20mm的病例,化验低密度脂蛋白胆固醇（LDL-C）,并对狭窄部位进行虚拟组织学血管内超声（VH-IVUS）检查,记录斑块组分（如脂质斑块、纤维斑块、钙化斑块、混合斑块及易损斑块）及结构（斑块负荷、最小管腔面积、管腔面积狭窄率、外弹力膜面积）的变化。入选43例患者给予瑞舒伐他汀钙10~20mg,控制LDL-C≤1.8mmol/L）。服用瑞舒伐他汀钙1年,重新做CAG及VH-IVUS。结果与治疗前相比,患者治疗后脂质斑块成分减少,易损斑块减少;纤维斑块及纤维混合斑块均增多;斑块负荷均明显下降（P〈0.05）;最小管腔面积增加;血管外弹力膜面积略有减少,正重构减轻。结论瑞舒伐他汀强化治疗能减少弥漫性长病变斑块的脂质成分,稳定斑块,减轻斑块负荷。Objectives To investigate the effects of rosuvastatin intensive lipid lowering therapy on plaque composition and structure of coronary artery with diffuse and long lesions. Methods The patients with vessel diameter stenosis ratio between 50% 70% ,and vessel long lesion more than 20 millimetre diagnosed by coronary angiography （CAG） were studied. Low density lipopro- rein cholesterol （LDL-C） was tested and lesion location was evaluated by virtual histology intravascular ultrasound （VH-IVUS） ~ Changes on plaque composition （ such as lipid plaque, fibrous plaque, calcific plaque, mixed plaque and vulnerable plaque ） and structure （ such as plaque burden, minimal lumen area, and external elastic membrane area ） were recorded. 43 eligible patients （LDL-C~〈I. 8mmol/L） with rosuvastatin 10 -20mg daily were enrolled. Keeping on taking rosuvastatin for one year,40 patients completed the trial and repeated CAG and VH-IVUS assay at last. Results Compared with pre-treatment,lipid plaque content and vulnerable plaque decreased （ P 〈 0.05 ） after rosuvastatin therapy, while fibrous plaque and mixed plaque increased （ P 〈 0. 05 ）. As for plaque burden, it decreased after therapy in the patients （ P 〈 0. 05 ） , Minimal lumen area increased in the patients （ P 〈 0. 05 ）. After therapy external elastic membrane area showed a slight decrease and positive remodeling alleviated. Conclusion Rosuvastatin intensive therapy could reduce lipid content in intermediate lesions, stabilize plaques and decrease plaque burden.

关 键 词：冠状动脉弥漫性长病变 斑块结构 瑞舒伐他汀 强化降脂 虚拟组织学血管内超声 

分 类 号：R541.4[医药卫生—心血管疾病]