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目的通过对136例颈动脉粥样硬化患者的观察,探讨阿托伐他汀调脂同时对颈动脉粥样硬化的影响。方法将136例颈动脉粥样硬化患者随机分为两组:治疗组72例,在给予饮食控制和改善生活方式的同时服用口服阿托伐他汀20mg,1次/d;对照组64例,仅给予饮食控制和改善生活方式,未服用任何调脂药物。两组均连续观察6月。两组患者在治疗前后均行彩色多普勒超声检测颈动脉。在纵切面上测量斑块的最大厚度(Tmax),计算其横切面最大面积(Smax),并统计斑块数量。每月测量1次肝肾功能、血流变、血糖及血压。结果二组治疗前后IMT、Tmax、Smax的变化以治疗组患者明显(P<0.05)。二组患者肝肾功能未见明显异常,治疗组患者发生2例TIA、3例心绞痛,对照组患者发生6例TIA、8例心绞痛,二组比较差异无统计学意义(P>0.05)。二组治疗前后斑块数量无减少。治疗组患者血脂明显下降,与治疗前比较差异有统计学意义(P<0.05)。结论阿托伐他汀安全、有效、耐受性好,不良反应少,在有效调脂同时可发挥其非调脂作用,延缓乃至逆转AS的发生发展,可作为伴有颈动脉粥样硬化患者的常规用药。
Objective To investigate the effects of atorvastatin on carotid atherosclerosis by observing 136 patients with carotid atherosclerosis. Methods A total of 136 patients with carotid atherosclerosis were randomly divided into two groups: treatment group (n = 72), oral administration of atorvastatin 20 mg once daily while diet control and lifestyle improvement were given; control group (n = 64), only Give dietary control and lifestyle improvements without taking any lipid-lowering medication. Both groups were observed continuously in June. Two groups of patients before and after treatment were performed color Doppler ultrasound carotid artery. The maximum thickness of the plaque (Tmax) was measured on the longitudinal section, the maximum area (Smax) of the cross section was calculated, and the number of plaques was calculated. A monthly measurement of liver and kidney function, blood rheology, blood glucose and blood pressure. Results Before and after treatment, the changes of IMT, Tmax and Smax in the treatment group were significantly (P <0.05). There was no obvious abnormal liver and kidney function in the two groups. TIA and angina pectoris occurred in 2 patients in the treatment group and 6 TIA and 8 angina pectoris patients in the control group. There was no significant difference between the two groups (P> 0.05). There was no decrease in the number of plaques in the two groups before and after treatment. Blood lipids in the treatment group decreased significantly compared with those before treatment (P <0.05). Conclusions Atorvastatin is safe, effective, well tolerated and has few adverse reactions. At the same time, atorvastatin can exert its non-lipid-lowering effect and delay or even reverse the development of AS. It can be used as a marker of carotid atherosclerosis Routine medication.