弹性应变率比值评价阿托伐他汀稳定颈动脉粥样斑块中短期疗效研究
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摘要
目的观察用弹性应变率比值法评价中短期稳定斑块疗效。方法选择颈总动脉斑块患者80例,分为A、B两组,A组患者每日给予阿托伐他汀20mg,B组患者每日给予阿托伐他汀40mg,分别于治疗前及治疗后3个月、6个月进行斑块弹性应变率比值测定。同时监测血清低密度脂蛋白-胆固醇(LDL-C)、高密度脂蛋白-胆固醇(HDL-C)、高敏C反应蛋白(hsCRP)浓度。结果⑴治疗3个月后A、B两组血清LDL-C、hs-CRP浓度较治疗前明显降低,差异有统计学意义(A组P<0.05,B组P<0.01),HDL-C较治疗前升高,A组无明显统计学差异,B组差异有统计学意义(P<0.05),治疗6个月后两组LDL-C、hs-CRP继续下降,但与3个月相比无明显统计学差异,HDL-C与3月比无明显变化。⑵A组治疗3个月后斑块弹性应变率比值较治疗前升高,但无统计学差异,6个月后较治疗前升高有统计学差异(P<0.05),但与3个月比无统计学差异;B组治疗3个月后斑块弹性应变率比值较治疗前明显升高,有统计学差异(P<0.05),治疗6个月继续升高,但与3个月相比无明显统计学差异。结论⑴应变率比值法可对斑块的硬度进行客观评价。⑵每日阿托伐他汀40mg比20mg更快增加斑块硬度从而稳定斑块,但远期疗效相差不明显。
Objective After the treatment of common carotid artery plaque with different doses of atorvastatin,the medium and short-term effects of stable plaque were evaluated by elastic strain rate ratio method. Methods Eighty patients with common carotid plaque were selected and divided into two groups,A and B. Group A patients received atorvastatin 20 mg daily. Group B patients received atorvastatin 40 mg daily. The plaque elastic strain rate ratio was measured before treatment and three months and six months after treatment. Serum low density lipoprotein-cholesterol(LDL-C),high density lipoprotein-cholesterol(HDL-C) and high sensitive C reactive protein(hs-CRP) concentrations were also monitored. Results ⑴After 3 months of treatment,the concentrations of serum LDL-C and hs-CRP in group A and group B were significantly lower than those before treatment. The difference was statistically significant(in group A<0.05,in group B<0.01). HDL-C was higher than before treatment,and there was no statistical difference in group A. The difference between group B was statistically significant(P<0.05). After 6 months of treatment,LDLC and hs-CRP continued to decrease in the two groups,but there was no statistically significant difference compared with 3 months. There was no significant change in HDL-C compared with 3 months. ⑵The ratio of plaque elastic strain rate after treatment in group A was higher than that before treatment,but there was no statistical difference. After 6 months,there was a statistical difference(P<0.05),but there was no statistical difference from 3 months. The ratio of plaque elastic strain rate after treatment in group B was significantly higher than that before treatment(P<0.05). The treatment continued to increase in 6 months,but there was no statistical difference compared with 3 months. Conclusion ⑴The elastic strain rate ratio method can objectively evaluate the hardness of plaque. ⑵Daily atorvastatin 40 mg faster than 20 mg to increase plaque hardness to stabilize plaque,but the longterm efficacy is not obvious.
Objective After the treatment of common carotid artery plaque with different doses of atorvastatin,the medium and short-term effects of stable plaque were evaluated by elastic strain rate ratio method. Methods Eighty patients with common carotid plaque were selected and divided into two groups,A and B. Group A patients received atorvastatin 20 mg daily. Group B patients received atorvastatin 40 mg daily. The plaque elastic strain rate ratio was measured before treatment and three months and six months after treatment. Serum low density lipoprotein-cholesterol(LDL-C),high density lipoprotein-cholesterol(HDL-C) and high sensitive C reactive protein(hs-CRP) concentrations were also monitored. Results ⑴After 3 months of treatment,the concentrations of serum LDL-C and hs-CRP in group A and group B were significantly lower than those before treatment. The difference was statistically significant(in group A<0.05,in group B<0.01). HDL-C was higher than before treatment,and there was no statistical difference in group A. The difference between group B was statistically significant(P<0.05). After 6 months of treatment,LDLC and hs-CRP continued to decrease in the two groups,but there was no statistically significant difference compared with 3 months. There was no significant change in HDL-C compared with 3 months. ⑵The ratio of plaque elastic strain rate after treatment in group A was higher than that before treatment,but there was no statistical difference. After 6 months,there was a statistical difference(P<0.05),but there was no statistical difference from 3 months. The ratio of plaque elastic strain rate after treatment in group B was significantly higher than that before treatment(P<0.05). The treatment continued to increase in 6 months,but there was no statistical difference compared with 3 months. Conclusion ⑴The elastic strain rate ratio method can objectively evaluate the hardness of plaque. ⑵Daily atorvastatin 40 mg faster than 20 mg to increase plaque hardness to stabilize plaque,but the longterm efficacy is not obvious.
引文
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[5]包纪盛,陈亚萍,林志,等.阿托伐他汀在高龄患者中应用的疗效与安全性观察[J].中国临床保健杂志,2008,11(6):634-635.
[6]徐尚志.辛伐他汀及阿司匹林对高血压病合并颈动脉粥样硬化的干预性的对比研究[J].江西医药,2008,43(6):552-555.
[7]Sacco RI,Adamas R,Albers G,et al.guidelines for preventions of stroke in patients with ischemic stroke or transient ischemic attack a statement for healthcare professionals form the American heart Association/American Stroke association Council on stroke cosponsored by the council on Cardiovascular Radiology and Intervention The American Academy of Neurology affirms the value of this guideline[J].Circulation,2006,113:409-449.
[8]孙恕,幸志强,邱丽红,陈芳明,廖勋凯.急性冠状动脉综合征患者血清MMP-1的临床意义[J].江西医药,2011,46(3):242-243.
[9]张丽.血清高敏C反应蛋白与心血管病关系的研究进展[J].国际检验医学杂志,2006,27(5):4354 37.
[10]翁静,董伟.2型糖尿病患者合并脑梗死危险因素分析[J].江西医药,2007,42(7):621-622.
[2]伍玉晗,邓又斌,刘金成,等.实时超声弹性成像评价颈动脉粥样硬化斑块[J].中华超声影像学杂志,2009,18(9):762-764.
[3]Pickerell DM,RT(R),RDMS,et al.Elastography:imaging of tomorrow[J].Diagnostic Medical Sonography,2010,26(3):109-113.
[4]方占军,高启旺,张连杰,等.实时超声弹性成像技术评价脑卒中患者颈动脉斑块软硬度[J].医学临床研究,2011,28(9):659-660.
[5]包纪盛,陈亚萍,林志,等.阿托伐他汀在高龄患者中应用的疗效与安全性观察[J].中国临床保健杂志,2008,11(6):634-635.
[6]徐尚志.辛伐他汀及阿司匹林对高血压病合并颈动脉粥样硬化的干预性的对比研究[J].江西医药,2008,43(6):552-555.
[7]Sacco RI,Adamas R,Albers G,et al.guidelines for preventions of stroke in patients with ischemic stroke or transient ischemic attack a statement for healthcare professionals form the American heart Association/American Stroke association Council on stroke cosponsored by the council on Cardiovascular Radiology and Intervention The American Academy of Neurology affirms the value of this guideline[J].Circulation,2006,113:409-449.
[8]孙恕,幸志强,邱丽红,陈芳明,廖勋凯.急性冠状动脉综合征患者血清MMP-1的临床意义[J].江西医药,2011,46(3):242-243.
[9]张丽.血清高敏C反应蛋白与心血管病关系的研究进展[J].国际检验医学杂志,2006,27(5):4354 37.
[10]翁静,董伟.2型糖尿病患者合并脑梗死危险因素分析[J].江西医药,2007,42(7):621-622.