美托洛尔和阿托伐他汀对颈动脉粥样硬化作用的对比研究

目的比较美托洛尔和阿托伐他汀对颈动脉粥样硬化的作用。方法颈动脉粥样硬化患者90例，随机分为3组：A纽（琥珀酸美托洛尔缓释片治疗组47．5mg／d-95．0mg／d），B组（阿托伐他汀钙片治疗组20mg／d），C组（琥珀酸美托洛尔缓释片47．5mg／d-95．0mg／d加阿托伐他汀钙片20mg／d治疗组），每组30例，共治疗24周。治疗前及治疗后12周、24周测定3组患者的血脂、高敏C反应蛋白（hsCRP）、纤维蛋白原（FIB）等生化指标；并行颈动脉多普勒超声检查，记录双侧颈动脉内膜-中层厚度最大值（IMTmax）、计算颈动脉斑块积分等指标。结果A组患者的血脂水平在治疗后12周、24周与治疗前比较无明显变化（P〉0．05），B组、C组患者的血脂水平在治疗后12周、24周与治疗前比较，总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL—C）均显著降低，高密度脂蛋白（HDL—C）显著升高（P〈0．05）；B组、C组患者的EIB水平在治疗后12周、24周与治疗前比较均有所降低；3组患者的hsCRP水平在治疗后12周、24周与治疗前比较均显著降低，IMTmax、颈动脉斑块积分数值均显著减少（P〈0．05）。组间治疗后12周、24周与A组比较，B组、C组患者的hsCRP及IMTmax降幅较大，C组患者的hsCRP又较B组降幅大（P〈0．05）。治疗后24周，与B组比较，C组患者的IMTmax降幅较大（P〈0．05）。结论美托洛尔和阿托伐他汀均可延缓颈动脉粥样硬化的发展并消退颈动脉粥样斑块。

The Comparative Study of the Influence with Metoprolol and Atorvastatin on Carotid Atherosclerosis

Objective To compare the effect of metoprolol and atorvastatin on carotid atherosclerosis. Methods Ninety patients （pts） with carotid atherosclerotic were randomly divided into three groups （30 pts in each group）： A group （metoprolol succinate sustained-release tablets group 47. 5 mg/d to 95.0 mg/d ）,B group （atorvastatin calcium tablets group 20 mg/d） and C group （metoprolol succinate sustained - release tablets 47.5 mg/d to 95.0 mg/d with atorvastatin calcium tablets 20 mg/d）. At the beginning, 12 th week, 24 th week of the study, the blood fat, high sensitivity C -reactive protein （hsCRP）, fibrinogen （FIB） and the maximal intima- media thickness （IMTmax） were measured. The plaque scores were calculated at the same time. Results Following the treatment of 12 weeks and 24 weeks,there was almost no effect on blood fat in A group （P〉0.05）. But the level of TC, TG and LDL- C were decreased,the HDL- C was increased in B group and C group （P〈0.05）. The FIB was decreased in B group and C group HsCRP,IMT and the plaque score were decreased in all groups （P〈0.05）. At the end of 12 th week and 24 th week,compared with that in A group,the decrease of hsCRP and IMTmax in the other two groups were more significant. The decrease of hsCRP in C group was more significant than that in B group （P〈0.05）. At the end of 24th week,the decrease of IMTmax in C group was more significant than that in B group （P〈0.05）. Conclusion Both of metoprolol arid atorvastatin could retardthe progressive development of carotid atherosclerosis and the carotid artery plaque could be regressed.