舒降之、普罗布考和开搏通对颈动脉和股动脉内膜中膜厚度的影响  

The Effects of Simvastatin Probucol and Captopril on the Intima Media Thickness of Carotid and Femoral Arteries

作　　者：张梅[1] 张运[1] 张园园[1] 高月花[1] 

机构地区：[1]山东大学齐鲁医院心内科,山东省济南市250012

出　　处：《中国动脉硬化杂志》2004年第1期61-64,共4页Chinese Journal of Arteriosclerosis

基　　金：山东省卫生厅"九五"攻关项目 ( 9711)

摘　　要：应用高频超声显像技术探讨舒降之、普罗布考和开搏通对动脉粥样硬化患者颈动脉和股动脉内膜中膜厚度的影响。在 10 2例患者中 ,应用高频超声技术测量颈动脉和股动脉后壁内膜中膜的正常厚度、最大厚度、四条动脉最大厚度的平均值和四条动脉中单个最大厚度 ,同时测量管壁的僵硬度 β。然后分别服用舒降之、普罗布考、开搏通三年后复查。结果发现 ,各组治疗前后斑块部位内膜中膜厚度均增加 (P均 <0 .0 5 )。对照组正常厚度的变化值 (0 .0 4± 0 .12mm)均显著高于普罗布考组的右颈动脉 (0 .0 4± 0 .12mm)和舒降之组左颈动脉 (0 .0 4± 0 .2 6mm)及右股动脉 (0 .0 3± 0 .2 3mm) (P <0 .0 5 )。舒降之组最大厚度、四条动脉最大厚度的平均值和各治疗组右侧股动脉最大厚度的变化值显著低于对照组 (P <0 .0 5 )。舒降之组 (0 .17± 0 .12mm)和开搏通组 (0 .2 1± 0 .15mm)四条动脉最大厚度的平均值的变化率显著低于对照组 (0 .2 5± 0 .2 0mm) (P均 <0 .0 1)。各组四条动脉中单个最大厚度的变化值及变化率显著低于对照组 (P均 <0 .0 5 )。本研究结果表明 ,动脉粥样硬化斑块较正常内膜—中膜厚度进展较快 ,药物治疗延缓动脉粥样硬化的进展 ,以舒降之作用最佳。Aim To evaluate the therapeutic effects of simvastatin probucol and captopril on the atherosclerotic plaques with high-frequency ultrasound imaging. Methods 102 patients with atherosclerosis were randomly divided into 4 groups: the simvastatin group, the probucol group, the captopril group, and the placebo group. Both sides of carotid and femoral arteries were detected with a 4～10 MHz transducer and intima-media thickness (IMT)were determined. IMT of normal segment of each artery was defined as IMTa, the maximal IMT of each artery as IMTb, the mean maximal IMT of 4 arteries as IMTc, the maximal IMTc of 4 arteries as IMTd. The systemic examinations were repeated in 3 years after treatments. Results After 3 years treatment IMT values increased significantly in the atherosclerosis arteries (P<0.05). The change values of IMTa in control group (0.04±0.12 mm) was larger than that of the right carotid artery in probucol group (0.04±0.12 mm) and the left carotid artery(0.04±0.26 mm) and right femoral artery (0.03±0.23 mm)in simvastatin group (P<0.05). The pregression values of IMTb and IMTc in simvastatin group and IMTb in all therapetic groups were singnificantly lowered than that of control group (P<0.05). The pregression rates of IMTc in simvastatin group (0.17±0.12 mm)and captopril group (0.21±0.15 mm) were singnificantly lowered than that of control group (0.25±0.2 mm) (P<0.01). The pregression value and rate of IMTd in all therapetic groups were significantly lower than that of control group (P<0.05). Conclusions The drug theray can decrease the progression of atherosclerosis but had no effect on the normal segment of arteries. The high frequence ultrasound technique provides a reliable routine for monitoring progression or regression of atherosclerosis in carotid and femoral arteries.

关 键 词：内科学 三种药物对颈动脉内膜中膜厚度的影响 血管内超声检测 颈动脉 股动脉 内膜中膜厚度 动脉粥样硬化 消退治疗 

分 类 号：R541.4[医药卫生—心血管疾病]