他汀类药物对动脉粥样硬化的疗效研究

Effect of statins on atherosclerosis

摘要:

探讨他汀类药物对动脉粥样硬化患者的疗效及其作用机制。方法选取该院收治的动脉粥样硬化患者104 例，随机分为对照组、辛伐他汀组、普伐他汀组、阿托伐他汀组，分别给药治疗。测定4 组患者在治疗前和治疗6 个月后的的三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）及低密度脂蛋白胆固醇（LDC-C）水平，同时测定其双侧总动脉内膜- 中层的厚度、粥样斑块的最大直径和厚度，用分光光度计检测血液中一氧化氮NO和一氧化氮合成酶（NOS）的含量，并统计患者出现不良反应的例数。结果实验组在治疗后TG、TC和LDC-C 值呈现下降趋势，HDL-C值呈上升趋势，与对照组比较，差异有统计学意义（p <0.05），而辛伐他汀组、普伐他汀组、阿托伐他汀组比较，差异无统计学意义（p >0.05）。实验组治疗有效率高达70.08%，与对照组比较，差异有统计学意义（p <0.05）。实验组的IMT 及斑块的最大直径与治疗前比较，差异有统计学意义（p <0.05），而各组间比较，差异无统计学意义（p >0.05）。实验组NO及NOS 水平与治疗前及对照组比较，差异有统计学意义（p <0.05），实验组NO和NOS 水平升高。随访结果表明，他汀类药物在使用过程中安全有效。结论他汀类药物治疗动脉粥样硬化安全、有效、可靠，并能有效调节患者血液中NO、NOS 含量，值得在临床上大力推广。

Abstract:

To investigate the effect of statins on atherosclerosis and its mechanism. Methods Totally 104 patients with atherosclerosis were selected and randomly divided into control group, Simvastatin group, Pravastatin group and Atorvastatin group. The levels of triacylglycerol (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDC-C) were determined. And the maximum length and thickness of atherosclerotic plaques and the intima-media thickness (IMT) were measured, and the content of NO and NOS in blood were measured by spectrophotometry. The number of patients with adverse reactions were counted. Results The levels of TG, TC and LDL-C in the treatment groups showed a decreasing trend, but HDL-C was in a rising trend after treatment; the differences were statistically significant compared with the control group (p < 0.05), while there were no significant differences among the three treatment groups (p > 0.05). The treatment efficiency was up to 70.08% in the treatment groups, there were significant differences compared to the control group (p < 0.05). In the statin groups, the maximum diameter of the atherosclerotic plaques and IMT after treatment were significantly different from those before treatment (p < 0.05),but there were no significant differences among the three statin groups (p > 0.05). Compared with the control group and before treatment, the levels of NO and NOS in the treatment groups were significantly increased after treatment (p < 0.05). Follow-up results showed that statins were safe and effective in the process of treatment. Conclusions Statins are safe, effective and reliable for the treatment of atherosclerosis, and can effectively regulate the content of NO and NOS, which are worthy to be popularized in clinical practice.