Investigation of the effects of intensive atorvastatin treatment on carotid arterial plaque in the coronary artery disease patients receiving percutaneous coronary intervention
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摘要:
目的本研究在于探讨强化阿托伐他汀治疗对经皮冠状动脉介入治疗(percutaneous coronary intervention, PCI)的冠心病(coronary artery disease, CAD)患者颈动脉斑块的影响。 方法选择在南京医科大学第一附属医院住院择期行PCI的CAD患者120例，随机分为常规治疗组60例，强化阿托伐他汀治疗组60例。在术前、术后1个月、术后6个月分别测定颈动脉内中膜厚度(intima media thickness, IMT)、斑块面积(plaque area, PA)。 结果常规及强化他汀治疗组中的颈动脉IMT、PA比较有统计学差异[PCI术后1个月：IMT，OR=0.62，95%CI (0.13-3.05)，P=0.015；PA，OR=0.78，95%CI (0.09-1.69)，P=0.041；PCI术后6个月：IMT，OR=0.58，95%CI (0.10-2.90)，P=0.013；PA，OR=0.70，95%CI (0.11-1.78)，P=0.035]。 结论PCI围手术期给予阿托伐他汀强化治疗减少了CAD患者颈动脉IMT及PA。 -
关键词:
- 强化阿托伐他汀治疗 /
- 冠心病 /
- 经皮冠状动脉介入治疗 /
- 内中膜厚度 /
- 斑块面积
Abstract:ObjectiveWe studied the effect of intensive atorvastatin treatment on carotid arterial intima media thickness (IMT) and plaque area (PA) in coronary artery disease (CAD) patients receiving percutaneous coronary intervention (PCI) in the present study. Methods120 CAD patients were randomly divided into two groups in our study. The carotid arterial IMT and PA before and 1 month, 6 months after PCI were then measured. ResultsThe carotid arterial IMT and PA significantly decreased in the intensive atorvastatin treatment group compared to conventional treatment group [One month after PCI, IMT, OR=0.62, 95% CI (0.13-3.05), P=0.015; PA, OR=0.78, 95% CI (0.09-1.69), P=0.041. Six months after PCI, IMT, OR=0.58, 95% CI (0.10-2.90), P=0.013;PA, OR=0.70, 95% CI (0.11-1.78), P=0.035]. ConclusionsThe carotid arterial IMT and PA would be significantly reduced for the CAD patients receiving PCI who has been given the enhanced atorvastatin treatment. -
表 1 所有受试者的基本资料(n=60)
特征 A组 B组 P 年龄 63.0±8.5 60.4±9.3 < 0.001 性別(男），n(%) 42(70.0%) 39(65%) < 0.001 体质量指数 24.0±2.9 23.5±3.0 0.180 高血压病，n(%) 33(55%) 30(50.0%) 0.752 糖尿病，n(%) 18(30.0%) 12(20.0%) 0.465 高脂血症，n(%) 12(20.0%) 9(15%) 0.677 吸烟，n(%) 21(35%) 18(30%) 0.736 总胆固醇 4.41±1.12 4.26±1.19 0.205 总卄油三脂 2.56±1.08 1.87±1.13 < 0.001 高密度脂蛋白胆固醇 1.15±0.41 1.26±0.45 < 0.001 低密度脂蛋白胆固醇 2.72±0.82 2.51±0.69 < 0.001 年龄，总甘油三脂，总胆固醇，高密度脂蛋白胆固醇，低密度脂蛋白胆固醇(平均数±标准差)为非正态分布，使用Mann-Whitney U检验。体质量指数(平均数±标准差)是正态分布，使用独立样本t检验进行比较。其他数据表述为频率和百分比，并使用卡方检验。P < 0.05被认为是具有统计学差异；组A，常规治疗组；组B，强化他汀治疗组. 
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表 2 强化阿托伐他汀和常规治疗组中患者PCI术后1个月颈动脉IMT、PA比较
组別 IMI (mm) PA (mm2) HDL-C (mmol/l) LDL-C (mmol/l) 治疗前 治疗后1个月 治疗前 治疗后1个月 治疗前 治疗后1个月 治疗前 治疗后1个月 A组 1.19±0.17 1.08±0.21 15.99±1.20 15.99±1.20 1.15±0.41 1.20±0.40 2.72±0.82 2.45±0.79 B组 1.33±0.26 1.20±0.32 15.13±1.53 15.13±1.53 1.26±0.45 1.32±0.31 2.51±0.69 2.13±0.58 P 0.015 0.041 0.040 < 0.05 P < 0.05.
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表 3 强化阿托伐他汀和常规治疗组中患者PCI术后6个月颈动脉IMT、PA比较
组別 IMI (mm) PA (mm) HDL-C (mmol/l) LDL-C (mmol/l) 治疗前 治疗后6个月 治疗前 治疗后6个月 治疗前 治疗后6个月 治疗前 治疗后6个月 A组 1.19±0.17 1.00±0.18 15.99±1.20 12.70±1.28 1.15±0.41 1.24±0.43 2.72±0.82 2.30±0.75 B组 1.33±0.26 1.13±0.26 15.13±1.53 11.06±1.32 1.26±0.45 1.35±0.41 2.51±0.69 2.01±0.43 P 0.013 0.035 0.048 < 0.05 P < 0.05.
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