大剂量辛伐他汀对冠心病患者颈动脉内膜中层厚度及斑块稳定性的影响

目的 分析辛伐他汀对冠心病患者颈动脉内膜中层厚度（IMT）及斑块稳定性的影响.方法 选取冠心病患者112例,依据随机原则分为观察组56例和对照组56例,2组在常规治疗的基础上,对照组给予常规剂量辛伐他汀治疗,观察组给予大剂量辛伐他汀治疗,疗程均为1年.比较2组血脂、IL-6、TNF-α、颈动脉IMT、颈动脉壁厚度（CAWT）以及斑块性质差异.结果 与对照组比较,观察组的TC、LDL-C及IL-6、TNF-α水平下降,分别为（4.06±0.63）mmol/L vs （5.43±0.85） mmol/L、（2.52±0.58） mmol/L vs （3.14±0.51） mmol/L、（132.4±10.7）ng/ml vs （218.6±18.6） ng/ml、（0.96±0.21）ng/ml vs （1.43±0.28） ng/ml,而HDL-C水平增加 （1.60±0.41）mmol/L vs （1.43±0.38） mmol/L];颈动脉IMT及CAWT数值均显著降低,分别为（0.62±0.19）mm vs（0.98±0.24） mm、（0.9±0.3）mm vs （1.8±0.4） mm;观察组的软斑块及纤维斑块比例降低,分别为19.24% vs 31.58%、40.85% vs 50.44%,而钙化斑块比例增加（39.91% vs 17.98%）,2组间比较差异均有统计学意义（P〈0.05）.结论 大剂量辛伐他汀可改善冠心病患者颈动脉IMT,同时促进斑块稳定性.

Effect of high dose simvastatin on intima media thickness of carotid artery and plaque stability in patients with coronary heart disease

Objective To observe the effect of simvastatin on intima media thickness of common carotid artery（IMT） and plaque stability in patients with coronary heart disease（CHD）.Methods A total of 112 patients with CHD were randomly divided into two groups：Observation group（n = 56）,received conventional therapy plus by high dose simvastatin,control group（n =56）,received conventional dose simvastatin.All patients were received anti-CHD therapy for one year.The levels of lipid indexes,IL-6,TNF-α,carotid IMT,carotid artery wall thickness（CAWT） and the ratios of all kinds of plaque between two groups were compared.Results Compared to control group,the levels of TC,LDL-C,IL-6 and TNF-α in observation group were lower,which were（4.06＋0.63） mmol/L vs（5.43±0.85） mmol/L,（2.52±0.58） mmol/L vs（3.14 ±0.51） mmol/L,（132.4±10.7） ng/ml vs（218.6 ± 18.6） ng/ml,（0.96 ±0.21） ng/ml vs（1.43 ±0.28） ng/ml,but the level of HDL-C was higher,which was（1.60 ±0.41） mmol/L vs（1.43±0.38） mmol/L,and the levels of IMT and CAWT were lower,which were（0.62 ±0.19） mm vs（0.98 ±0.24） mm,（0.9 ±0.3） mm vs（1.8＋0.4） mm,the ratios of soft plaque and fibrous plaque in observation group were lower,which were 19.24%vs 31.58%,40.85%vs50.44%,but the ratio of calcified plaque in observation group was higher,which was 39.91%vs 17.98%（all P 0.05）.Conclusion High dose of simvastatin can improve carotid artery IMT and plaque stability on patients with CHD.