阿托伐他汀与通心络治疗颈动脉粥样硬化斑块的临床观察

目的：探讨阿托伐他汀和通心络对颈动脉粥样硬化斑块和血脂的影响。方法：选择67例颈动脉硬化斑块患者,随机分成3组,阿托伐他汀组、通心络组、联合治疗组（阿托伐他汀＋通心络）,观察12周。观察治疗前后患者颈动脉内膜-中层厚度,斑块面积,斑块积分和血脂的变化。结果：3组治疗前后颈动脉IMT和斑块面积均缩小,斑块总积分减少,治疗后与治疗前相比差异有统计学意义,组间比较,联合治疗组颈动脉IMT和斑块面积和斑块总积分优于单药治疗组,差异有统计学意义（P〈0.05,P〈0.01）,阿托伐他汀组与通心络组比较,治疗后颈动脉IMT和斑块面积,差异有统计学意义（P〈0.05）,斑块总积分差异无统计学意义（P〉0.05）。联合治疗组TC、LDL-C、TG下降幅度均高于单独用药组,差异有统计学意义（P〈0.05）,通心络组治疗前后TG差异有统计学意义（P〈0.05）。阿托伐他汀组与通心络组治疗后比较,TC、LDL-C、TG差异有统计学意义（P〈0.05）,通心络组降TG效果优于阿托伐他汀组（P〈0.05）,差异有统计学意义。结论：阿托伐他汀和通心络联合治疗作用互补,对颈动脉内膜-中层厚度,斑块面积,斑块积分和血脂的影响大于单药治疗。

Clinical Observation on Atorvastatin with Tongxinluo for the Treatment of Carotid Atherosclerotic Plaques

Objective： To explore the effect of Tongxinluo and Atorvastatin on carotid atherosclerotic plaque and blood lipid. Methods：Selected 67 patients with carotid atherosclerotic plaques,randomly divided into 3 groups,i. e. Atorvastatin group,Tongxinluo group and combination group（ Atorvastatin ＋ Tongxinluo）,observed 12 weeks. Carotid artery intima-middle thickness,plaque area,plaque integral and changes in blood lipids were observed. Results： Each treatment group＇s carotid artery IMT and plaques area was decreased and total plaque score lowered after treatment（ P〈0. 01）. Comparison between groups regarding carotid IMT and plaque area and the total score： Atorvastatin ＋ Tongxinluo group was better than the single drug groups with statistical difference. Atorvastatin group was significantly better（ P〈0. 05） than Tongxinluo group except for plaques total score（ P〈0. 05）. Combination group TC TG,LDL- C declined greater than other groups（ P〈0. 05）. Tongxinluo group TG declined significantly after treatment（ P〈0. 05）. TAtorvastatin group showed better effect on TC TG,LDL- C difference（ P〈0. 05）,and Tongxinluo group was better to reduce TG（ P〈0. 05）.Conclusion： Atorvastatin in combination with Tongxinluo has better curative effect on carotid intima- middle thickness,plaque area,plaque score and blood lipids than monotherapy.