摘要
目的观察长期使用阿托伐他汀对于高龄（≥80岁）患者颈动脉粥样硬化病变的影响及安全性。方法61例患者进入研究，给予阿托伐他汀（20mg／d）治疗，随访5年，治疗前后检测颈动脉彩色多普勒超声及血脂、血糖、肝肾功能及肌酸激酶等。结果56例患者完成随访，治疗前后比较，低密度脂蛋白胆固醇（LDL-C）显著降低（P〈0．05），而高密度脂蛋白胆固醇（HDL-C）显著升高（P〈O．05），空腹总胆固醇、三酰甘油、血糖、血尿素、肌酐、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、血清总胆红素（STB）、结合胆红素（CB）、肌酸激酶（CK）治疗前后比较，差异无统计学意义（P〉0．05）。斑块面积总和显著减少[（0．63±0．41）cm。比（1．07±0．67）cm^2，t=2．118，P〈0．053，而斑块回声积分显著增加[（2．67±0．52）分比（1．53±0．44）分，t=2．771，P〈0．05]，但内一中膜厚度变化差异无统计学意义[（0．11±0．02）em比（0．12±0．02）cm，t=1．528，P〉0．053。结论阿托伐他汀可以用于高龄（≥80岁）患者，长期治疗后可使动脉粥样硬化斑块缩小而且变成稳定的斑块。
Objective To investigate the effect and safety of long-term use of atorvastatin on carotid atherosclerosis in advanced elderly patients. Methods Totally 61 elderly patients with carotid atherosclerosis were permitted into study. They were treated with atorvastatin （20 rng/d） and followed-up for five years. The carotid atherosclerosis parameter and the serum levels of TC, TG, LDL-C, HDL-C, fasting blood glucose （FBG）, ALT, AST, STB, CB, Bun, Cr and creatine kinase （CK） were measured before and 5 years after treatment. Results During fellow-up, 2 patients died of severe pneumonia and 1 patient died of operation complications of intestinal obstruction, with mortality rate of 4.9%. 2 patients （3.4%） gave up treatment because of muscle-related side-effect. Data was collected in 56 patients achieving study end. There was significant decrease in LDL-C （P〈 0.05） and increase in HDL-C （P〈0.05）, but there was no change in serum levels of TC, TG, FBG, ALT, AST, STB, CB, BUN, Cr and CK （P〈0.05） after 5 years. The total area of carotid atherosclerosis plaque was reduced [（0.63±0. 41）cm2 vs. （1.07±0.67）cm2 , P〈0.05] and echo of carotid atherosclerosis plaque was enhanced （2.67 ± 0.52 vs. 1.53 ± 0.44, P〈0.01）, but carotid intima-media thickness（IMT） appeared no change after five years. Conclusions Atorvastatin is safe in the treatment of advanced elderly patients, it can make carotid atherosclerosis plaque smaller and stable after long-term treatment.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2012年第11期974-976,共3页
Chinese Journal of Geriatrics
关键词
抗胆固醇血症药
颈动脉疾病
动脉粥样硬化
Anti-cholesterolemic agents
Carotid artery diseases
Atherosclerosis
