强化降脂联合抗血小板聚集干预对颈动脉粥样硬化的影响

目的观察强化降脂干预对颈动脉粥样硬化的影响。方法 120例合并颈动脉粥样硬化及血脂异常的缺血性脑血管病患者按随机数字表分为阿斯匹林＋辛伐他丁常规剂量组（常规剂量组）、阿斯匹林组及强化降脂联合抗血小板聚集组（强化降脂组）,每组40例,分别给予相应的药物治疗6个月,比较3组治疗前后血清C-反应蛋白（CRP）、血脂水平及颈动脉内膜中层厚度（IMT）、颈动脉斑块面积的变化及脑血管事件复发率。结果 3组治疗后血清CRP水平均较前显著降低（均P〈0.05）;常规剂量组和强化降脂组治疗后IMT、斑块面积及血脂水平较阿斯匹林组明显降低（均P〈0.05）;阿司匹林组治疗前后IMT、斑块面积及血脂水平差异无统计学意义（P〉0.05）;强化降脂组治疗后较常规剂量组IMT、斑块面积及血脂CRP水平改善更明显（均P〈0.05）,与另外2组比较缺血性脑血管病复发率有明显差异（P〈0.05）。结论强化降脂联合抗血小板聚集治疗对降低CRP及血脂水平,延缓和逆转颈动脉粥样硬化优于使用阿斯匹林＋辛伐他丁常规剂量组及单纯抗血小板聚集药,并可预防缺血性脑血管病复发。

Intensive Lipid-lowering Intervention in the Joint Anti-blood Plate Platelet Aggregation Effects of Carotid Artery Atherosclerosis

Objective To observe the intensive lipid-lowering intervention on carotid atherosclerosis effects.Methods 120 patients with carotid atherosclerosis and dyslipidemia in patients with ischemic cerebrovascular disease were randomly divided into the aspirin＋simvastatin conventional dose group,aspirin group and intensive lipid-lowering combined antiplatelet aggregation group with 40 patients in each group,were given appropriate medications for 6 months after treatment compared three groups of serum c-reactive protein（CRP）,lipid levels and carotid artery intima-media thickness（IMT）,carotid artery plaque area change and the recurrence rate of cerebral vascular events.Results 3 groups after treatment of serum CRP levels were significantly deareased（all P0.05）;of aspirin＋simvastatin combined conventional-dose and intensive lipid-lowering therapy antiplatelet group IMT,plaque area and lipid levels significantly lower than the aspirin group（all P0.05）;of aspirin before and after treatment IMT,plaque area and lipid levels showed no significant difference（P0.05）;intensive lipid-lowering joint aspirin group after treatment compared with aspirin＋simvastatin conventional dose group,IMT,plaque area and lipid CRP levels improved more significantly（all P0.05）,with the other two groups of ischemic cerebrovascular disease recurrence rate were significantly different（P0.05）.Conclusion Intensive lipid-lowering therapy on the joint anti-platelet aggregation and lower CRP levels,lower blood lipid levels,delay and reverse carotid atherosclerosis than aspirin＋simvastatin alone conventional dose group and anti-platelet aggregation drugs,and can prevent recurrence of ischemic cerebrovascular disease.