OCT观察不同剂量阿托伐他汀对ACS患者脂质斑块纤维帽的影响  

Effect of different doses of atorvastatin on vulnerable plaque, fibrous cap and lipid core angle of coronary arteries in patients with acute coronary syndrome

作　　者：王世奇[1] 胡烨文[1] 贺甫威[1] 叶红华[1] WANG Shiqi HU Yewen HE Fuwei. et al(Heart Center of Ningbo First Municipal Hospital, Ningbo 315000, China)

机构地区：[1]宁波市第一医院心脏中心,315000

出　　处：《浙江医学》2017年第17期1465-1468,共4页Zhejiang Medical Journal

基　　金：宁波市科技计划项目(2011C51003)

摘　　要：目的通过光学相干断层扫描技术(OCT)观察不同剂量阿托伐他汀对急性冠状动脉综合征(ACS)患者冠状动脉易损脂质斑块纤维帽及脂质核心角度的影响。方法选取接受经皮冠状动脉介入(PCI)的ACS患者24例,根据他汀剂量不同分为常规剂量组12例和强化剂量组12例,PCI术后分别接受常规阿托伐他汀20、40~80mg治疗。手术即刻及术后第9个月行OCT检查,记录脂质斑块纤维帽的部位及数量,比较斑块最薄纤维帽厚度和脂质核心角度。结果常规剂量组易损斑块纤维帽厚度随访与基线期分别为(175.42±36.02)、(50.41±6.58)μm(P<0.01),强化剂量组分别为(233.33±88.35)、(49.12±7.33)μm(P<0.01);两组随访期易损斑块纤维帽厚度差异无统计学意义(P>0.05);常规剂量组TCFA脂质核心角度随访与基线期分别为(72.9±29.3)°、(127.6±50.8)°(P<0.01),强化剂量组分别为(74.6±32.9)°、(132.6±51.3)°(P<0.01),两组患者基线与随访时脂质核心角度差异均无统计学意义(均P>0.05)。结论阿托伐他汀可使随访期TCFA厚度增大,脂质核心角度减小,采用OCT可重点观察TCFA厚度。Objective To investigate the effects of different doses of atorvastatin on vulnerable plaque,fibrous cap and lipid core angle of coronary arteries in patients with acute coronary syndrome （ACS）.Methods Twenty four ACS patients undergoing percutaneous coronary intervention（PCI） from 2011 to 2014 in our hospital were randomly divided into two groups with 12 in each.Patients in routine dose group received 20mg atorvastatin after PCI and those in high dose group received 40-80mg atorvastatin.Patients underwent optical coherence tomography（OCT） examination before and 9 months after PCI,the number and location of thin-cap fibroatheroma （TCFA） were recorded and the fibrous cap thickness and plaque lipid core point were measured.Results The vulnerable plaque fibrous cap thickness were increased after PCI compared with baseline both in routine dose group （175.42 ± 36.02 vs 50.41 ± 6.58 μm,P〈0.05） and high dose group（233.33 ± 88.35 vs 49.12 ± 7.33 μm,P〈0.05）,and there was significant difference between two groups during the follow-up period（P〈0.047）.The TCFA lipid core angle at follow-up was decreased compared to baseline both in routine dose group （72.9 ± 29.3° vs 127.6 ± 50.8°,P〈0.05） and in high dose group （74.6 ± 32.9° vs 132.6 ± 51.3°,P〈0.05）,and there was no significant difference between two groups at baseline and follow-up.Conclusion Compared with the baseline,the thickness of TCFA in ACS patients with routine dose or high dose atorvastatin are increased,and the lipid core angle are decreased significantly.

关 键 词：急性冠状动脉综合征 光学相干断层显像 易损斑块纤维帽 脂质核心角度 

分 类 号：R541.4[医药卫生—心血管疾病]