不同剂量立普妥对老年颈动脉内膜-中层厚度影响.docVIP

不同剂量立普妥对老年颈动脉内膜-中层厚度影响摘要：目的利用高频彩超观察不同剂量立普妥对老年颈动脉内膜-中层厚度（IMT）的影响。方法将符合标准的100例患者，采用临床随机原则分为两组，试验一组口服立普妥10 mg/d （n=51），试验二组口服立普妥20 mg/d（n=49），疗程6个月。观察治疗前后颈动脉IMT变化及药物不良反应。结果两组药物治疗6个月后与治疗前组内比较颈总动脉和双侧颈动脉分叉处IMT有明显改善（P0.05)；两组组间比较IMT则无统计学意义(P0.05)。不良反应发生率组间比较无统计学意义（P0.05），未发现严重肝肾功受损及肌酶升高。结论从卫生经济学出发，每日10 mg立普妥即可达到较好的治疗效果，而且是安全、有效的；彩超可以准确、方便地评价不同剂量的立普妥对颈动脉内膜-中层厚度的影响，是首选的影像检查方法。 关键词：立普妥 颈动脉 内膜-中层厚度 老年人 中图分类号：R541.4R256.2文献标识码：B文章编号：1672-1349(2011)05-0529-03 Effect of Different Doses of Lipitor on Carotid IMT in Elelerly Patients Zhang Lin，Liang Xiaoqiu，Xiong Ming，et al// The Fifth Peoples Hospital of Chengdu（Chengdu611130） Abstract:ObjectiveTo explore the effect of different doses of lipitor on carotid intima-media thickness (IMT) in gerontal patients (pts) and the value of high frequency color Doppler ultrasonography for carotid IMT.MethodsOne hundred gerontal pts were randomly divided into two groups.The pts in first group (n=51) were given lipitor 10 mg and the pts in second group (n=49) were given lipitor 20 mg every day.Following treatment for 6 months，the carotid IMT was observed pretherapy and post-therapy.ResultsThere was a significant improvementin the common carotid artery and its bifurcation IMT after treatment for 24 weeks（P0.05)．There was no statistical difference in the IMT between the two groups (P0.05)．And the incidence rate of adverse events between the two groupshad no significant statistical difference (P0.05)．There were no patients with the severe damage of liver function and the increase of creatase.ConclusionWith the view of the medical economics，10 mg lipitor every day was safe and effective.Color Doppler ultrasound could monitor the carotid artery IMT accurately and conveniently. Key words：lipitor；carotid artery；intima-media thickness；gerontal patient 颈动脉粥样硬化与冠状动脉粥样硬化之间有着密切的联系，颈动脉粥样硬化与心脑血管疾病显著相关，是全身动脉粥样硬化早期评价和预测指标，已经成为全球首位死亡原因［1-3］。近10多年来，有关调脂治疗的多项临床循证医学试验（RCT）都是在西方国家进行的，中国患者至今未能参加到这些研究中。针对血清胆固醇水平及冠心病发生率相对较低的中国人，究竟哪种剂量立普妥在IMT增厚及粥样硬化