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阿托伐他汀对无症状颈动脉疾病的高胆固醇血症患者 2 年治疗对内膜中层厚度的影响。

Effect of 2-year treatment with low-dose rosuvastatin on intima-media thickness in hypercholesterolemic subjects with asymptomatic carotid artery disease.

机构信息

San Camillo de Lellis Hospital, Cardiology Unit, Via Isonzo, Manfredonia, Foggia, Italy.

出版信息

Expert Opin Pharmacother. 2011 Dec;12(17):2599-604. doi: 10.1517/14656566.2011.618497. Epub 2011 Oct 15.

Abstract

OBJECTIVES

Recent evidence indicates that rosuvastatin 40 mg may exert a beneficial effect in both carotid and coronary atherosclerosis progression. In particular, 2-year rosuvastatin treatment reduced the progression of carotid intima-media thickness (cIMT) in patients with low cardiovascular risk. However, despite the fact that in clinical practice lower doses of rosuvastatin are usually administered at this time, there are no clear data about its effect on cIMT. Thus, the aim of this study was to evaluate the effect of rosuvastatin 10 mg/day on cIMT over a 2-year follow-up.

METHODS

Forty-five patients with hypercholesterolemia and asymptomatic carotid atherosclerosis on baseline carotid ultrasound investigation were treated with rosuvastatin 10 mg/day for 24 months. cIMT and lipid profile were assessed after 12 months and at the end of the study (24 months).

RESULTS

After 24 months, the treatment showed a 35.67% reduction in low-density lipoprotein cholesterol concentration (171 vs 110 mg/dl; p < 0.001), a 32.27% reduction in total cholesterol (251 vs 170 mg/dl; p < 0.001), a 19.67% increase in high-density lipoprotein cholesterol concentration (49 vs 61 mg/dl; p < 0.001), and a 10% reduction in triglycerides (120 vs 108 mg/dl; p < 0.01). Rosuvastatin treatment was associated with a 26.6% reduction in left cIMT (1.20 vs 0.90 mm; p < 0.001) and a 22.2% reduction in right cIMT (1.22 vs 0.95 mm; p < 0.001).

CONCLUSION

Two-year treatment with rosuvastatin 10 mg/day in hypercholesterolemic adults with evidence of subclinical atherosclerosis establishes a significant reduction in cIMT and improves lipid and lipoprotein levels, with a good tolerability profile.

摘要

目的

最近的证据表明,瑞舒伐他汀 40 毫克可能对颈动脉和冠状动脉粥样硬化进展都有有益的影响。特别是,2 年瑞舒伐他汀治疗降低了低心血管风险患者的颈动脉内膜中层厚度(cIMT)进展。然而,尽管此时通常给予较低剂量的瑞舒伐他汀,但尚无关于其对 cIMT 影响的明确数据。因此,本研究的目的是评估瑞舒伐他汀 10 毫克/天在 2 年随访期间对 cIMT 的影响。

方法

在基线颈动脉超声检查中,45 例患有高胆固醇血症和无症状颈动脉粥样硬化的患者接受瑞舒伐他汀 10 毫克/天治疗 24 个月。在 12 个月和研究结束时(24 个月)评估 cIMT 和血脂谱。

结果

经过 24 个月,治疗后低密度脂蛋白胆固醇浓度降低 35.67%(171 与 110mg/dl;p<0.001),总胆固醇降低 32.27%(251 与 170mg/dl;p<0.001),高密度脂蛋白胆固醇浓度升高 19.67%(49 与 61mg/dl;p<0.001),甘油三酯降低 10%(120 与 108mg/dl;p<0.01)。瑞舒伐他汀治疗与左侧 cIMT 降低 26.6%相关(1.20 与 0.90mm;p<0.001),右侧 cIMT 降低 22.2%相关(1.22 与 0.95mm;p<0.001)。

结论

在有亚临床动脉粥样硬化证据的高胆固醇血症成人中,2 年瑞舒伐他汀 10 毫克/天治疗可显著降低 cIMT 并改善血脂和脂蛋白水平,具有良好的耐受性。

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