阿托伐他汀对脑梗死患者颈动脉斑块稳定性及血管内皮功能的影响  

Effect of Atorvastatin on Carotid Plaque Stability and Vascular Endothelial Function in Patients with Cerebral Infarction

作　　者：周利胜[1] 李杰文 谢伟琼 邓镇强 陆健辉 ZHOU Lisheng;LI Jiewen;XIE Weiqiong(Gaoming District People’s Hospital of Foshan City,Foshan 528500,Chin)

机构地区：[1]广东省佛山市高明区人民医院,广东佛山528500

出　　处：《中国医学创新》2018年第20期33-37,共5页Medical Innovation of China

基　　金：2017年佛山市自筹经费类科技计划项目(2017AB001084)

摘　　要：目的:探讨阿托伐他汀对脑梗死颈动脉斑块患者颈动脉斑块稳定性及血管内皮功能的影响。方法:选取2015年6月-2017年6月本院神经内科收治的脑梗死颈动脉斑块患者120例作为研究对象,按照随机数字表法将其分为A组、B组和C组,每组40例。A组接受常规基础治疗,B组加用常规剂量阿托伐他汀(20 mg/次),C组加用大剂量阿托伐他汀(40 mg/次),持续治疗6个月。分别于治疗前、治疗6个月后采用彩色超声诊断仪测定三组患者的颈动脉内膜中层厚度(intima media thickness,IMT)并计算斑块积分,测定三组患者的血脂组分、血清一氧化氮(NO)、血管内皮素-1(ET-1)、可溶性细胞间黏附分子-1(soluble intercellular adhesion molecule-1,s ICAM-1)水平和血管内皮生长因子(vascular endothelial growth factor,VEGF)水平,同时评价三组临床治疗效果。结果:治疗后,B、C组患者的IMT值和斑块积分均明显低于治疗前;B组IMT值和斑块积分比A组均明显降低,C组比A、B组均降低得更显著,差异均有统计学意义(P<0.05)。治疗后,B、C组患者的血清NO和VEGF水平均明显高于治疗前,ET-1和s ICAM-1水平均明显低于治疗前;B组NO和VEGF水平比A组均明显升高,ET-1和s ICAM-1水平均明显降低;C组NO和VEGF水平比A、B组均升高得更显著,ET-1和s ICAM-1水平均降低得更显著,差异均有统计学意义(P<0.05)。治疗后,B、C组的血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均明显低于治疗前,高密度脂蛋白胆固醇(HDL-C)水平明显高于治疗前;B组TC、TG、LDL-C水平比A组均明显降低,HDL-C水平明显升高;C组TC、TG、LDL-C水平比A、B组均降低得更显著,HDL-C水平均升高得更显著,差异均有统计学意义(P<0.05)。结论:阿托伐他汀能够有效减少脑梗死颈动脉斑块患者的颈动脉内中膜厚度和斑块积分,显著改善患者的血管内皮功能,稳定颈动脉粥样硬化斑块,并且大剂量的阿托伐他Objective：To explore the effect of Atorvastatin on carotid plaque stability and vascular endothelial function in patients with cerebral infarction.Method：A total of 120 patients with cerebral infarction and carotid plaques treated in neurology department of our hospital from June 2015 to June 2017 were selected as the research objects.According to the random number table method,they were divided into group A,group B and group C.The group A was received routine treatment,the group B was treated with conventional dose of Atorvastatin（20 mg each time）,the group C was treated with high dose Atorvastatin（40 mg each time）.All patients were received continuous treatment for 6 months.The intima media thickness（IMT）,the plaque score,the serum lipid,the levels of serum nitric oxide（NO）,endothelin-1（ET-1）,soluble intercellular adhesion molecule-1（s ICAM-1） and vascular endothelial growth factor（VEGF） were detected and calculated by color Doppler ultrasound before treatment and after 6 months of treatment among the three groups.At the same time,the clinical therapeutic effect of three groups were evaluated.Result：After treatment,the IMT values and plaque scores in group B and C were significantly lower than those before treatment;the IMT value and plaque score in group B were significantly lower than those in group A and those in group C were decreased more significantly than those in group A and B,the differences were statistically significant（P〈0.05）.After treatment,the levels of serum NO and VEGF in group B and C were significantly higher than those before treatment,the levels of ET-1 and s ICAM-1 were significantly lower than those before treatment;the levels of serum NO and VEGF in group B were significantly higher than those in group A,the levels of ET-1 and s ICAM-1 were significantly lower than those in group A;the levels of serum NO and VEGF in group C were increased more significantly than those in group A and B,the levels of ET-1 and s ICAM-1 were decreased more significantl

关 键 词：脑梗死 颈动脉斑块 血管内皮功能 阿托伐他汀 

分 类 号：R743.3[医药卫生—神经病学与精神病学]