杂合子家族性高胆固醇血症患者的 LDL-c 长期降低可使颈动脉内膜中层厚度正常化。

Long-term LDL-c lowering in heterozygous familial hypercholesterolemia normalizes carotid intima-media thickness.

机构信息

Department of Vascular Medicine, Academic Medical Centre, F4-159.2, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.

出版信息

Atherosclerosis. 2010 Oct;212(2):571-4. doi: 10.1016/j.atherosclerosis.2010.06.040. Epub 2010 Jul 22.

DOI:10.1016/j.atherosclerosis.2010.06.040

PMID:20655044

Abstract

OBJECTIVE

We investigated the effectiveness of statins in daily practice in reducing the arterial wall thicknesses by comparing the carotid intima-media thickness (cIMT) between statin-treated familial hypercholesterolemia (FH) patients and their unaffected spouses.

METHODS

FH subjects treated with LDL-c lowering medication for at least 5 years and their unaffected spouses were included in this observational study. Clinical data and carotid intima-media thickness (cIMT) as surrogate marker for atherosclerosis were acquired.

RESULTS

In total 40 FH patients, age 48.4±4.2 years, and their 40 unaffected spouses, age 47.4±3.9 years, were included. Pre-treatment total cholesterol levels of FH patients were on average 9.3±2.0 mmol/L. Treated FH patients and unaffected spouses exhibited similar LDL-c (3.8±1.5 vs. 3.5±1.1 mmol/L; p=0.25) and total cholesterol levels (5.8±1.6 vs. 5.6±1.1 mmol/L; p=0.56). Also, in a multivariate model cIMT adjusted for age and sex did not differ between affected and spouses (95% CI: -0.032 to 0.092 mm; p=0.34).

CONCLUSION

Long-term statin treatment normalizes cIMT in severe FH patients and therefore it is likely that the extreme risk of cardiovascular disease in FH patients is significantly reduced by this therapy.

摘要

目的

通过比较他汀类药物治疗的家族性高胆固醇血症（FH）患者及其未受影响的配偶的颈动脉内膜中层厚度（cIMT），来研究他汀类药物在日常实践中降低动脉壁厚度的效果。

方法

本观察性研究纳入了至少接受 5 年 LDL-c 降低药物治疗的 FH 患者及其未受影响的配偶。获取了临床数据和颈动脉内膜中层厚度（cIMT）作为动脉粥样硬化的替代标志物。

结果

共纳入 40 名 FH 患者（年龄 48.4±4.2 岁）和 40 名未受影响的配偶（年龄 47.4±3.9 岁）。FH 患者的治疗前总胆固醇水平平均为 9.3±2.0 mmol/L。治疗后的 FH 患者和未受影响的配偶的 LDL-c（3.8±1.5 与 3.5±1.1 mmol/L；p=0.25）和总胆固醇水平（5.8±1.6 与 5.6±1.1 mmol/L；p=0.56）相似。此外，在调整年龄和性别后，受影响患者和配偶之间的 cIMT 也无差异（95%CI：-0.032 至 0.092 mm；p=0.34）。