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阿托伐他汀与依替膦酸二钠联合治疗对磁共振成像评价的主动脉粥样硬化斑块消退的影响。

Effect of atorvastatin and etidronate combination therapy on regression of aortic atherosclerotic plaques evaluated by magnetic resonance imaging.

机构信息

Department of Internal Medicine, Niigata Rosai Hospital, Joetsu, Japan.

出版信息

J Atheroscler Thromb. 2011;18(5):384-95. doi: 10.5551/jat.7104. Epub 2011 Jan 26.

Abstract

AIM

Although statins have been well documented to induce the regression of thoracic aortic plaques, a similar effect of statins on abdominal aortic plaques has not been observed.We aimed to explore whether a statin in combination with a bisphosphonate was effective in the regression of abdominal aortic plaques, which are more likely to be calcified.

METHODS

Eighty-seven patients with hypercholesterolemia were assigned to the atorvastatin (ATR)+etidronate (ETD) group (n = 45) or ATR group (n = 42). A total of 98 thoracic and 107 abdominal aortic plaques were detected in the ATR+ETD group, and 86 thoracic and 102 abdominal plaques in the ATR group at baseline, as measured by magnetic resonance imaging (MRI). The primary endpoint was the change of maximal vessel wall thickness (Max-VWT) in atherosclerotic lesions after 1 year, as assessed by MRI.

RESULTS

ATR+ETD and ATR groups reduced the low density lipoprotein cholesterol level (-42% and -43%, p < 0.001 vs. baseline for both groups), and Max-VWT in thoracic lesions (-15% and -14%, p < 0.001 vs. baseline for both groups). ATR+ETD group reduced Max-VWT in abdominal lesions (-14%, p < 0.001 vs. baseline), whereas ATR group did not (-1%, p =0.958 vs. baseline).

CONCLUSION

The results suggest that ATR+ETD treatment for 12 months significantly reduces both thoracic and abdominal aortic plaques, while ATR treatment reduces only thoracic aortic plaques.

摘要

目的

尽管他汀类药物已被充分证实可使胸主动脉斑块消退,但尚未观察到他汀类药物对腹主动脉斑块具有类似的作用。我们旨在探讨他汀类药物联合双膦酸盐是否对腹主动脉斑块(更有可能发生钙化)的消退有效。

方法

将 87 例高胆固醇血症患者分为阿托伐他汀(ATR)+依替膦酸(ETD)组(n = 45)或 ATR 组(n = 42)。通过磁共振成像(MRI)检测,ATR+ETD 组基线时共检测到 98 个胸主动脉斑块和 107 个腹主动脉斑块,ATR 组分别为 86 个胸主动脉斑块和 102 个腹主动脉斑块。主要终点是通过 MRI 评估 1 年后动脉粥样硬化病变的最大血管壁厚度(Max-VWT)变化。

结果

ATR+ETD 组和 ATR 组均降低了低密度脂蛋白胆固醇水平(-42%和-43%,p < 0.001 与两组基线相比),以及胸病变的 Max-VWT(-15%和-14%,p < 0.001 与两组基线相比)。ATR+ETD 组降低了腹主动脉病变的 Max-VWT(-14%,p < 0.001 与基线相比),而 ATR 组则没有(-1%,p = 0.958 与基线相比)。

结论

结果表明,ATR+ETD 治疗 12 个月可显著减少胸主动脉和腹主动脉斑块,而 ATR 治疗仅减少胸主动脉斑块。

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