阿托伐他汀鈣對頸動脈粥樣硬化患者血管內皮的保護作用_《華西醫學》

作者：

劉坤梅 , 丁小君 , 劉修燕 , 陽恩

四川省第四人民醫院神經內科（成都，610016）;

關鍵詞：

阿托伐他汀鈣頸動脈粥樣硬化斑塊血管內皮功能斑塊逆轉

DOI：

10.7507/1002-0179.20130007

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目的　探討阿托伐他汀鈣對頸動脈粥樣硬化患者血管內皮的保護作用。方法　選取2010年10月－2011年8月頸動脈粥樣硬化患者80例，隨機分為治療組和對照組。對照組給予阿司匹林腸溶片0.1 g，早飯后口服1次；治療組在此基礎上給予阿托伐他汀鈣20 mg，每晚口服1次，10個月為1個療程。分別在治療前后進行頸動脈彩色多普勒超聲檢測頸動脈中膜厚度及頸動脈粥樣硬化斑塊面積，測定甘油三酯（TG）、總膽固醇（TC）、低密度脂蛋白膽固醇（LDL-C）、高密度脂蛋白膽固醇（HDL-C）、一氧化氮（NO）、血管內皮素-1（ET-1）水平。兩組患者在1個療程治療結束后停藥12周，測定TG、TCH、LDL-C、HDL-C、NO、ET-1水平。結果　與治療前比較，治療組患者的TG、TC、LDL-C、ET-1水平顯著降低，HDL-C、NO水平顯著升高（P＜0.01）。頸動脈中膜厚度和頸動脈粥樣硬化斑塊面積明顯變小（P＜0.05）。對照組無明顯變化。治療組停藥12周后與停藥時比較，TG、TC、LDL-C、ET-1水平顯著升高，HDL-C、NO水平明顯降低（P ＜0.05）。對照組無明顯變化。結論　阿托伐他汀鈣能顯著改善頸動脈粥樣硬化斑塊患者的血管內皮功能、血脂水平，穩定頸動脈粥樣硬化斑塊，促進斑塊逆轉，且需要長期堅持服用。

引用本文： 劉坤梅,丁小君,劉修燕,陽恩. 阿托伐他汀鈣對頸動脈粥樣硬化患者血管內皮的保護作用. 華西醫學, 2013, 28(1): 25-27. doi: 10.7507/1002-0179.20130007 復制

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1. 　Henry JM, Barnett JP, Bennett M, et al. 卒中病理生理, 診斷及其治療[M]. 高旭光，譯. 3版. 沈陽: 遼寧科學技術出版社，2001: 13-15.
2. 　Korybalska K, Kawka E, Breborowicz A, et al. Atorvastatin does not impair endothelial cell wound healing in an in vitro model of vascular injury[J]. J Physiol Pharmacol, 2012, 63(4): 389-395.
3. 　他汀類藥物預防缺血性卒中/短暫性腦缺血發作專家組. 他汀類藥物預防缺血性卒中/短暫性腦缺血的專家建議[J]. 中華內科雜志, 2007, 46(1): 8l-82.
4. 　van Schie RM, Verhoef TI, Boejharat SB, et al. Evaluation of the effect of statin use on the acenocoumarol and phenprocoumon maintenance dose[J]. Drug Metabol Drug Interact, 2012, 27(4): 229-234.
5. 　Barth JD. An update on carotid ultrasound measurement of intima-media thickness[J]. Am J Cardiol, 2002, 89(4A): 32B-38B.
6. 　鄒艷華, 戈曉華. 頸動脈超聲多普勒實習手冊[M]. 北京: 學苑出版社, 1996: 6-7.
7. 　Kadoglou NP, Sailer N, Moumtzouoglou A, et al. Adipokines: a novel link between adiposity and carotid plaque vulnerability[J]. Eur J Clin Invest, 2012, 42(12): 1278-1286.
8. 　Grundy SM，Cleeman JI，Merz CN，et al．Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel Ⅲ guidelines[J].Circulation, 2004, 110 (2): 227-239.
9. 　Bo?entowicz-Wikarek M, Koce?ak P, Smertka M, et al. Effectiveness of lipid-lowering therapy with statins for secondary prevention of atherosclerosis-guidelines vs. reality[J]. Pharmacol Rep, 2012, 64(2): 377-385.
10. 　Pramanik S, Das AK, Chakrabarty M, et al. Efficacy of alternate-day versus everyday dosing of atorvastatin[J]. Indian J Pharmacol, 2012, 44(3): 362-365.
11. 　Kitamura A, Iso H, Imano H，et al. Carotid intima-media thickness and plaque characteristics as a risk factor for stroke in Japanese elderly men[J]. Stroke, 2004, 35(12): 2788-2794.
12. 　Eussen SR, Rompelberg CJ, Klungel OH, et al. Modeling approach to simulate reductions in LDL cholesterol levels after combined intake of statins and phytosterols/-stanols in humans[J]. Lipids Health Dis, 2011,10: 187.

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阿托伐他汀鈣對頸動脈粥樣硬化患者血管內皮的保護作用

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阿托伐他汀鈣對頸動脈粥樣硬化患者血管內皮的保護作用

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