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目的:评价他汀类药物对轻度胆固醇升高冠心病患者冠状动脉粥样硬化斑块的影响。方法:将49例LDL-C 3.6~2.6 mmol/L冠心病患者分为2组,他汀组23例;非他汀组26例。每位患者选取1处狭窄50%~70%的病变为靶病变。入院时和12个月后分别行冠状动脉造影(CAG)和靶病变的血管内超声(IVUS),比较治疗前后斑块体积、管腔体积和血管体积。结果:他汀组12个月后,LDL-C由(3.44±0.42)mmol/L降至(2.31±0.19)mmol/L,较入院时下降32.8%;非他汀组12个月后较入院时基本无变化。血管体积、管腔体积和斑块体积在入院时2组差异无统计学意义。12个月后,非他汀组斑块体积显著增加,由(82.1±14.5)mm3增加至(95.9±20.5)mm3(P<0.05);血管体积无明显变化;管腔体积缩小,由(55.1±7.8)mm3减少至(44.6±6.6)mm3(P<0.05)。他汀组12个月后的斑块体积、血管体积和管腔体积均无明显变化。结论:他汀类药物可以阻止LDL-C轻度升高的冠心病患者冠状动脉斑块的进展。
OBJECTIVE: To evaluate the effect of statins on coronary atherosclerotic plaques in patients with mild cholesterol and elevated coronary heart disease. Methods: 49 cases of LDL-C 3.6-2.6 mmol / L coronary heart disease were divided into two groups, the statin group of 23 patients; non-statin group of 26 patients. Each patient selected a narrow 50% to 70% of the lesion as the target lesion. Coronary angiography (CAG) and target lesion intravascular ultrasound (IVUS) were performed at admission and 12 months later. The plaque volume, lumen volume and vessel volume were compared before and after treatment. Results: In the statin group, LDL-C decreased from (3.44 ± 0.42) mmol / L to (2.31 ± 0.19) mmol / L after 12 months, and decreased 32.8% No change. Vascular volume, lumen volume and plaque volume at admission were no significant difference between the two groups. After 12 months, the volume of plaque in non-statin group increased significantly from (82.1 ± 14.5) mm to (95.9 ± 20.5) mm3 (P <0.05) 7.8) mm3 to (44.6 ± 6.6) mm3 (P <0.05). There was no significant change in plaque volume, vascular volume and lumen volume in the statin group after 12 months. Conclusion: Statins prevent the progression of coronary plaque in patients with mildly elevated LDL-C.