超声造影评价他汀药物对糖尿病及非糖尿病病人颈动脉斑块内新生血管的影响  

Effects of Statins on the Neovascularization in Carotid Plaque in Patients with Diabetes Mellitus and Non-diabetes Mellitus by the Contrast-enhance Ultrasound Evaluation

作　　者：陈建梅[1] 王秋霜[1] 黄党生[1] 张丽伟[1] 王淑华[1] 姬冬冬[1] 郭家瑞[1] 

机构地区：[1]中国人民解放军总医院第一附属医院,北京100048

出　　处：《中西医结合心脑血管病杂志》2017年第11期1292-1296,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：解放军总医院科技创新苗圃基金项目(No.14KMM26)

摘　　要：目的采用超声造影评价他汀药物对糖尿病及非糖尿病病人颈动脉斑块内新生血管的影响。方法选择2014年8月—2016年2月在我院门诊与住院诊治的颈部有斑块的糖尿病与非糖尿病人110例,根据血糖情况分为糖尿病组(55例)与非糖尿病组(55例),所有病人给予他汀药物进行降脂治疗,记录血脂变化情况与预后情况,同时进行常规超声与超声造影的动态观察与评价。结果两组治疗后的三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)含量均明显低于治疗前(P<0.05);高密度脂蛋白胆固醇(HDL-C)含量明显高于治疗前(P<0.05)。糖尿病组治疗前后颈动脉斑块内新生血管发生率明显高于非糖尿病组(P<0.05)。治疗前糖尿病组的超声造影基础强度(BI)和峰值强度(EI)明显高于非糖尿病组(P<0.05);两组治疗后的EI与BI值明显下降(P<0.05),同时治疗后糖尿病组EI与BI值高于非糖尿病组(P<0.05)。治疗后糖尿病组的脑出血、短暂性脑缺血发作、新发脑梗死等终点事件发生率明显高于非糖尿病组(P<0.05)。结论他汀药物治疗糖尿病及非糖尿病病人有较好的降脂效果,常规超声与超声造影能有效反映颈动脉斑块内新生血管与造影强度的变化,可判断预后。Objective To evaluate the the effects of statin on the neovascularization in carotid plaques in patients with diabetes mellitus and non-diabetes mellitus by the contrast-enhance ultrasound evaluation.Methods One hundred and ten patients with carotid plaques,of which fifty-five patients with diabetes mellitus and fifty-five patients with non-diabetes mellitus,were selected from August 2014 to February 2016 in our hospital,and treated with statin.The changes of blood lipid and prognosis were observed and evaluated by conventional ultrasound and contrast-enhanced ultrasound.Results The levels of triglycerides（TG）,total cholesterol（TC）,low-density lipoprotein cholesterol（LDL-C）were decreased while high-density lipoprotein cholesterol（HDL-C）levels were increased in two groups after treatment（P〈 0.05）.The rates of neovascularization in carotid plaque in the diabetic group were significantly higher than that in non-diabetic group before and after treatment（P 〈0.05）.The contrast EI and Bi values in the diabetic group before treatment were significantly higher than that in non-diabetic group（P 〈0.05）.After treatment,EI and Bi values were significantly decreased in two groups（P 〈0.05）,which was significantly higher in the diabetic group than that in non-diabetic group（P 〈0.05）.After treatment,the incidence of cerebral hemorrhage,transient ischemic attack,and new cerebral infarction in the diabetic group were significantly higher that in the non-diabetic group（P〈 0.05）.Conclusion Statin has lipid-lowering effect in patients with diabetes mellitus or non-diabetes mellitus.The conventional ultrasound and contrast-enhanced ultrasound can more effectively reflect the changes of neovascularization in carotid plaque and contrast intensity,which is beneficial to the predict the prognosis.

关 键 词：糖尿病 颈动脉斑块 新生血管 超声造影 阿托伐他汀 造影强度 

分 类 号：R743[医药卫生—神经病学与精神病学]