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[他汀类药物治疗对家族性高脂蛋白血症患者颈总动脉内膜的有益作用]

[Favorable effect of treatment with statins on the intima of the common carotid artery in patients with familial hyperlipoproteinemia].

作者信息

Spácil J, Ceska R, Petrásek J, Sobra J

机构信息

III. interní klinika VFN a I. LF UK, Praha.

出版信息

Cas Lek Cesk. 1997 Aug 21;136(16):494-7.

PMID:9441006
Abstract

BACKGROUND

In recent years evidence was provided that by measuring the width of the intima of the carotid artery, evaluated by sonography, it is possible to assess the development of arteriosclerosis. The authors used this method to evaluate hypolipidaemic treatment.

METHODS AND RESULTS

The authors followed-up by clinical and laboratory methods and treated for a period of 47 months 63 patients with familial hyperlipoproteinaemia. At the beginning and at the end of the follow-up period they made sonographic examinations of the common carotid artery. In 31 patients treated by statins they observed statistically significant changes: cholesterol declined by 23%, LDL cholesterol by 25.3%. The maximal rate in the common carotid artery (ACC) declined from 93 +/- 22 to 73 +/- 13 cm/s. The diameters of the ACC increased from 6.0 +/- 0.8 to 6.5 +/- 0.8 mm. The intima of the ACC diminished from 0.84 +/- 0.26 to 0.75 +/- 0.20 mm. In 22 patients treated with fibrates the anticipated lipid changes occurred. The diameter of ACC did not change, the decline in the width of the intima of the ACC was not statistically significant. In 10 patients who decided that they wanted only dietary treatment the changes in the investigated parameters were small.

CONCLUSIONS

In patients with familial hyperlipidaemia who were treated with statins for almost four years the authors observed a diminution of the width of the intima of the common carotid artery which is considered a sign of regressing atherosclerosis.

摘要

背景

近年来有证据表明,通过超声评估颈动脉内膜宽度,有可能评估动脉硬化的发展情况。作者采用这种方法来评估降脂治疗效果。

方法与结果

作者采用临床和实验室方法对63例家族性高脂蛋白血症患者进行了为期47个月的随访和治疗。在随访期开始和结束时,对颈总动脉进行了超声检查。在31例接受他汀类药物治疗的患者中,他们观察到了具有统计学意义的变化:胆固醇下降了23%,低密度脂蛋白胆固醇下降了25.3%。颈总动脉(ACC)的最大血流速度从93±22降至73±13厘米/秒。ACC的直径从6.0±0.8增加到6.5±0.8毫米。ACC的内膜厚度从0.84±0.26减小到0.75±0.20毫米。在22例接受贝特类药物治疗的患者中,出现了预期的血脂变化。ACC的直径没有变化,ACC内膜宽度的减小没有统计学意义。在10例仅选择饮食治疗的患者中,所研究参数的变化很小。

结论

在接受他汀类药物治疗近四年的家族性高脂血症患者中,作者观察到颈总动脉内膜宽度减小,这被认为是动脉粥样硬化消退的迹象。

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