Blankenhorn D H, Azen S P, Crawford D W, Nessim S A, Sanmarco M E, Selzer R H, Shircore A M, Wickham E C
Department of Medicine, University of Southern California, Los Angeles 90033.
Circulation. 1991 Feb;83(2):438-47. doi: 10.1161/01.cir.83.2.438.
The 2-year therapy effect on femoral atherosclerosis was evaluated in the Cholesterol Lowering Atherosclerosis Study (CLAS), a randomized, placebo-plus-diet-controlled angiographic trial of colestipol-niacin therapy plus diet in men with previous coronary bypass surgery. Different diet compositions were prescribed to enhance the differential in blood cholesterol responses between the two groups. The annual rate of change in computer-estimated atherosclerosis (CEA), a measure of lumen abnormality, was evaluated between treatment groups. A significant per-segment therapy effect was found in segments with moderately severe atherosclerosis (p less than 0.04) and in proximal segments (p less than 0.02). When segmental CEA measures were combined into a per-patient score using an adaptation of the National Heart, Lung, and Blood Institute scoring procedure, a significant therapy effect was observed (p less than 0.02). Total variance of the annual change rate in CEA was as predicted from pilot studies, but measurement variation was larger. The therapy effect observed in femoral arteries, although significant, was less marked than the strong and consistent benefit previously reported for both native coronary arteries and aortocoronary bypass grafts.
在胆固醇降低动脉粥样硬化研究（CLAS）中评估了为期2年的股动脉粥样硬化治疗效果。该研究是一项随机、安慰剂加饮食对照的血管造影试验，对曾接受冠状动脉搭桥手术的男性采用考来烯胺 - 烟酸疗法加饮食进行治疗。规定了不同的饮食组成，以增强两组之间血液胆固醇反应的差异。在各治疗组之间评估了计算机估计的动脉粥样硬化（CEA，一种管腔异常的测量指标）的年变化率。在中度严重动脉粥样硬化的节段（p小于0.04）和近端节段（p小于0.02）发现了显著的节段性治疗效果。当使用美国国立心肺血液研究所评分程序的改编版将节段性CEA测量值合并为每位患者的评分时，观察到了显著的治疗效果（p小于0.02）。CEA年变化率的总方差与前期研究预测的一致，但测量变异更大。在股动脉中观察到的治疗效果虽然显著，但不如先前报道的天然冠状动脉和主动脉 - 冠状动脉搭桥移植物所具有的强烈且一致的益处那么明显。
