阿司匹林联合阿托伐他汀对缺血性脑血管病患者血清ox-LDL、炎性因子和颈动脉斑块的影响  

Effect of bayaspirin combined with atorvastatin on serum oxidized low density lipoprotein,inflammatory cytokines and carotid artery plaque in patients with ischemic cerebrovascular diseases

作　　者：王跃慧[1] 田跃雷[2] 梁文华 白莹[1] 吴玲玲[1] 

机构地区：[1]河北北方学院附属第二医院神经内科,河北省张家口市075100 [2]河北北方学院附属第二医院心内科,河北省张家口市075100 [3]河北省万全县医院内科

出　　处：《河北医药》2016年第11期1628-1631,共4页Hebei Medical Journal

基　　金：张家口市科学技术研究与发展指导计划项目(编号:1521054D)

摘　　要：目的观察缺血性脑血管病患者血清氧化型低密度脂蛋白(ox-LDL)、脂蛋白相关磷脂酶A2(LpPLA2)、超敏C-反应蛋白(hs-CRP)与颈动脉粥样硬化斑块的关系,并观察阿司匹林联合阿托伐他汀的治疗效果。方法缺血性脑血管病患者103例(病例组)包括IMT正常组20例,IMT增厚组15例,颈动脉斑块组68例(稳定斑块36例,不稳定斑块32例),同期体检的健康人80例为正常组。病例组随机分为对照组51例和观察组52例,均给予抗血小板聚集等常规治疗,观察组加用阿司匹林100 mg联合阿托伐他汀20 mg口服,疗程12个月。比较2组治疗前后血清ox-LDL、Lp-PLA2、hs-CRP及颈动脉IMT、斑块面积变化。结果 (1)血清ox-LDL、Lp-PLA2、hs-CRP水平病例组高于正常组(P<0.05);颈动脉斑块组高于IMT增厚组,IMT增厚组高于IMT正常组(P<0.05);颈动脉斑块组中不稳定斑块组高于稳定斑块组(P<0.05)。颈动脉斑块形成与血清ox-LDL、Lp-PLA2、hs-CRP水平呈正相关(P<0.05)。(2)治疗后对照组和观察组血清ox-LDL、Lp-PLA2、hs-CRP水平均较治疗前降低(P<0.05),同时颈动脉IMT、斑块面积缩小(P<0.05),且观察组均小于对照组(P<0.05)。结论缺血性脑血管病患者血清ox-LDL、LpPLA2、hs-CRP水平与动脉粥样硬化形成及发展有关,并可反映动脉粥样硬化程度。阿司匹林联合阿托伐他汀治疗缺血性脑血管病能降低患者血清ox-LDL、Lp-PLA2、hs-CRP水平,对延缓或逆转动脉粥样硬化斑块进展有积极意义。Objective To investigate the correlation between plasma oxidized low density lipoprotein（ ox-LDL）,lipoprotein-associated phospholipase A2（ Lp-PLA2）,high-sensitivity C-reactive protein（ hs-CRP） and pathogenesis of carotid artery plaque in patients with ischemic cerebrovascular diseases. Methods A total of 103 patients with ischemic cerebrovascular diseases were enrolled in the study（ case group）,who were divided into normal IMT group,IMT thickening group,carotid plaque group. 80 healthy subjects were served as control group. Besides the case group was redivided into case control group and observation group. All the patients were given conventional therapy（ anti-platelet aggregation,etc）,moreover,the patients in observation group were given bayaspirin 100 mg combined with atorvastatin 20 mg,with a treatment course of 12 months for both groups. After treatment,the serum levels of ox-LDL,Lp-PLA2,hs-CRP and changes of IMT and plaque area were detected and compared between two groups. Results The serum levels of ox-LDL,Lp-PLA2 and hs-CRP in case group were significantly higher than those in control group（ P〈0. 05）,moreover,which in carotid plaque group were significantly higher than those in IMT thickening group,furthermore,which in IMT thickening group were significantly higher than those in normal IMT group,which in unstable plaque group were significantly higher than those in stable plaque group（ P〈0. 05）. Pathogenesis of carotid plaque was closely correlated to the serum levels of ox-LDL,Lp-PLA2,hs-CRP（ P〈0. 05）. After 12-month treatment the serum levels of ox-LDL,Lp-PLA2 and hs-CRP in control group and observation group were obviously decreased,as compared with those before treatment,furthermore,which in observation group were significantly lower than those in control group at the same period（ P〈0. 05）. Meanwhile IMT and plaque area were obviously decreased in control group and observation group,moreover,the degree of decrease in observation group was more obvious than t

关 键 词：阿司匹林 阿托伐他汀 缺血性脑血管病 

分 类 号：R743.33[医药卫生—神经病学与精神病学]