辛伐他汀治疗TIA患者颈动脉粥样斑块临床观察

【目的】观察辛伐他汀对短暂性脑缺血发作（TIA）患者颈动脉斑块的治疗作用。【方法】对69例在近期出现过TIA发作且彩色多普勒超声检查确定有颈动脉粥样斑块患者随机分为治疗组（35例）和对照组（34例），对照组常规治疗中未使用他汀类药物，在此基础上，治疗组给予辛伐他汀20mg／d治疗6个月，两组治疗前后测定颈动脉粥样宽块大小、粥样斑块内膜一中层厚度（IMT）和血脂、C反应蛋白（CRP）。【结果】35例患者经辛伐他汀20mg／d治疗6个月，颈动脉粥样斑块明显缩小，以软斑最明显，混合斑次之，硬斑不明显，粥样斑块从IMT（1．42±0．45）mm降为（1．03±0．42）mm，下降幅度为27．4％，与对照组比较差异有显著性（P〈0．01）；C反应蛋白（CRP）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）降低，与对照组比较差异有显著性（P〈0．01）。【结论】辛伐他汀通过降低LDL-C，拮抗炎症反应，可以稳定逆转颈动脉粥样斑块。

Clinical Observation of Therapeutic Effects of Simvastatin on Transient Ischemic Attack Patients with Carotid Plaques

Objective]To observe the therapeutic effects of simvastatin on transient ischemia attack（TIA） patients with carotid plaques. Methods] Sixty nine TIA patients with carotid plaques diagnosed by using color ultrasound were categorized into two groups, namely the therapy group （ n=35） and the control group （ n=34）. The therapy group was treated with 20 mg/d of simvastatin for 6 months. The size of plaque, the intimamedia thickness （IMT）, blood lipid and C-reactive protein were measured before and after the treatment. Results] After 6 months of treatment with 20 mg/d of simvastatin, carotid plaques of 35 TIA patients obviously shrunk, especially soft carotid plaques, followed by mixed carotid plaques and hard carotid plaques. The IMT of carotid plaques dropped from 1.42±0.45mm to 1.03±0.42mm, or decreased by 27.4%. The contrastive differences in IMT between the therapy group and the control group had statistical significance （ P 〈0.01）. CRP, TC and LDL-C also dropped in treatment group, and the difference between two groups had statistical significance. Conclusion] Simvastatin is capable of steadily reverting carotid plaques by lowering LDL-C and resisting infection.