论文部分内容阅读
目的:探讨他汀类降脂药物对冠心病患者颈动脉内膜中层厚度(intimal medial thickness,IMT)和动脉反射波增强指数(augmentation index,AIx)的影响。方法:选取2009年3月～2010年3月经冠脉造影或冠脉CT血管重建明确诊断为冠心病同时伴高胆固醇血症,且入选前未服用降脂药物或曾服用但已停用血胆固醇再次升高的患者57例,口服阿托伐他汀20 mg。所有研究对象分别于入选后1周内、治疗后3、6个月测定IMT、AIx以及其他生化指标。结果:他汀类药物治疗后3、6个月时都能有效地改善血脂水平,但是IMT的变化不明显(均P>0.05),而AIx治疗前后有明显的统计学差异(均P<0.01),治疗前后以AIx为因变量,以IMT、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)为自变量进行多元回归分析结果,TC(治疗前r=0.55,t=4.32,P<0.01;治疗后r=0.69,t=4.96,P<0.01)和LDL-C(治疗前r=0.42,t=3.03,P<0.01;治疗后r=0.51,t=2.63,P<0.01)进入方程,统计分析表明TC、LDL-C和AIx呈正相关关系。结论:AIX较IMT能够更好地反映降脂治疗改善动脉硬化的效果。
Objective: To investigate the effects of statins lipid-lowering drugs on intimal medial thickness (IMT) and augmentation index (AIx) in patients with coronary heart disease. Methods: From March 2009 to March 2010 by coronary angiography or coronary CT angiography confirmed the diagnosis of coronary heart disease accompanied by hypercholesterolemia, and did not take before taking the lipid-lowering drugs or have taken but have been disabled blood cholesterol 57 cases of patients again increased, atorvastatin 20 mg. All subjects were tested for IMT, AIx, and other biochemical parameters within 1 week after enrollment and 3 and 6 months after treatment. Results: The level of blood lipids was improved at 3 and 6 months after statin treatment, but there was no significant change in IMT (all P> 0.05), but significant difference was observed before and after treatment with AIx (all P <0.01) , Before and after treatment with AIx as the dependent variable, with IMT, TC, TG, HDL-C and LDL-C as independent variables Regression analysis showed that TC (r = 0.55, t = 4.32, P <0.01; r = 0.69, t = 4.96, P <0.01) and LDL-C <0.01; r = 0.51 after treatment, t = 2.63, P <0.01) entered the equation. Statistical analysis showed that there was a positive correlation between TC, LDL-C and AIx. Conclusion: AIX is better than IMT to better reflect the effect of lipid-lowering therapy on atherosclerosis.