中国医科大学学报

中国医科大学学报

中国医科大学学报

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冠心病患者经皮冠状动脉介入治疗术后规范药物治疗对颈动脉粥样硬化的影响

李明琰,崔永生,何文凯,赵磊,邓秀芳   

  1. 广州医科大学附属第四医院心血管内科,广州511447
  • 收稿日期:2015-05-28 出版日期:2016-01-05 发布日期:2015-12-30
  • 作者简介:李明琰(1975 -),女,副主任医师,博士. E-mail:lmychg@126.com

Effects of Standard Medication Treatment on Atherosclerosis of Carotid Artery in Patients with Coronary Artery Disease after Percutaneous Coronary Intervention

LI Ming-yan,CUI Yong-sheng,HE Wen-kai,ZHAO Lei,DENG Xiu-fang   

  1. Department of Cardiology,The Fourth Affiliated Hospital of Guangzhou Medical University,Guangzhou511447,China
  • Received:2015-05-28 Online:2016-01-05 Published:2015-12-30

摘要:

目的 评价冠心病合并颈动脉粥样硬化患者经皮冠状动脉介入治疗(PCI)术后规范药物治疗对颈动脉粥样硬化的影响,并探讨其可能机制。方法 80例冠心病合并颈动脉粥样硬化患者PCI术后规范抗血小板聚集、他汀降脂等治疗,术前及术后12个月行颈动脉超声检查,测量颈动脉内膜中层厚度(IMT)和粥样硬化斑块积分,对比服药前后12个月内脑血管事件的发生率,测定超敏C反应蛋白、血脂水平、血常规的变化。结果 冠心病PCI术后规范治疗12个月与治疗前相比,甘油三酯、总胆固醇、低密度脂蛋白胆固醇、超敏C反应蛋白明显降低(P < 0.05),高密度脂蛋白胆固醇有所升高,但无统计学差异(P > 0.05);血常规中红细胞计数、白细胞计数、血红蛋白含量治疗前后相比无明显改变(P > 0.05),血小板计数较治疗前有所减少,但仍在正常范围,差异无统计学意义(P > 0.05);颈动脉IMT和粥样硬化斑块积分均较治疗前明显下降(P < 0.05);短暂性脑缺血发作的发作减少(P < 0.05)。结论 冠心病PCI术后规范药物治疗能明显改善血脂水平,减轻非特异性炎性反应,对颈动脉粥样硬化斑块有延缓和稳定作用,并可减少短暂性脑缺血发作的发生。

关键词: 冠心病, 经皮冠状动脉介入治疗, 颈动脉粥样硬化

Abstract:

Objective To evaluate the effects of standard medication atherosclerosis of common carotid artery in elderly patients with coronary artery disease after percutaneous coronary interventionPCI),and explore its possible mechanism. Methods A total of 80 cases of elderly patients

with carotid atherosclerosis who received PCI with standard medication were investigated. The standard medication was comprised of antiplatelet aggregation and statin lipid-lowering therapy. Ultrasound imaging was used to detect the changes of carotid artery intima-media thicknessIMTand artherosclerosis integral before administration and 12 months after administrationand the levels of high sensitivity C-reactive proteinblood fat and routine blood test were recorded and analyzed. Results Twelve months after treatment with standard medicationthe levels of triglyceridetotal cholesterollow-density lipoprotein cholesterol and high-sensitivity C-reactive protein were significantly decreasedP < 0.05),while high-density lipoprotein cholesterol was slightly increasedP > 0.05. Twelve months after standard medication treatmentthere were no significant differences of the counts of red cellwhite cell and the hemoglobin content in the bloodP > 0.05. The count of platelet has decreasedbut still within the normal rangeP > 0.05. The IMT and atherosclerosis integral of cartid artery were significantly decreasedP < 0.05. Furthermorethe occurrence frequency of transient ischemic attack was decreased. Conclusion Standard medication treatment after PCI is helpful in patients with coronary heart diseasewhich can gain the optimization of blood lipid levelreduce non-specific inflammationand lead to the more steady carotid atherosclerotic plaques and reduced incidence of transient ischemic attack.

Key words: coronary artery disease, percutaneous coronary intervention, atherosclerosis of carotid artery

中图分类号: 

  • R541.4
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