他汀类降脂药联合血管紧张素Ⅱ受体拮抗剂治疗冠状动脉病变的临床研究

摘要

Objective:To investigate the combined medication of statins(atorvastatin) and angiotensin receptor blocker, valsartan for their inhibition effect to systemic inflammation response in patients with coronary borderline lesions.Methods:110 patients with coronary borderline lesions diagnosed by 64-row multi-detector computed tomography (MDCT)were divided into two groups. Single medication group,n=55 ,the patients received atorvastatin for 6 months,and Combined medication group,n=55,the patients received both atorvastatin and valsartan for 6 months. We examined the plasma high sensitivity C-reactive protein(hs-CRP)and compared the coronary artery lesions by MDCT before and after the treatment in all patients.Results:Plasma hs-CRP decreased significantly in both groups after 6 months of treatment,P＜0. 01 respectively,and it was even lower in Combined medication group,P＜0. 05. MDCT presented an obvious reduction of lipid plaque volume and mixed plaque volume in both groups after the treatment,P＜0. 05, while there were no real changes of fibrous plaque volume and calcified plaque volume after the treatment P＞0. 05. The patients in Combined medication group had more reduction in their lipid plaque volume and mixed plaque volume compared than that in Single medication group,P＜0. 05 respectively,but no obvious differences in fibrous plaque volume and calcified plaque volume between two groups,P＞0. 05 respectively.Conclusion:Combined medication of statins(atorvastatin) and angiotensin receptor blocker, valsartan, can inhibit the systemic inflammatory response and stabilize the coronary plaque in patients with coronary borderline lesions.%目的:观察经64层螺旋计算机断层摄影术(CT)诊断为冠状动脉临界病变的患者给予阿托伐他汀联合缬沙坦治疗6个月后冠状动脉斑块的变化,探讨他汀类联合血管紧张素Ⅱ受体拮抗剂抑制炎性反应、稳定冠状动脉斑块的协同作用.方法:经64层螺旋CT诊断为冠状动脉临界病变的患者110例,随机分为两组:阿托伐他汀治疗组(A组)55例,阿托伐他汀+缬沙坦联合治疗组(B组)55例,分别检测两组患者治疗前、药物治疗6个月后,血浆高敏C反应蛋白水平以及冠状动脉斑块的变化情况.结果:药物治疗6个月后与治疗前相比,两组患者高敏C反应蛋白水平均降低(P均<0.01),且B组较A组降低显著(P<0.05),差异均有统计学意义.治疗后与治疗前相比,两组脂质斑块、混合斑块明显减小(P<0.05～0.01),差异均有统计学意义;纤维斑块和钙化斑块变化均不明显(P均>0.05).B组与A组相比,脂质斑块、混合斑块缩小幅度更明显(P均<0.05),差异均有统计学意义;纤维斑块、钙化斑块变化不明显(P均>0.05).结论:应用他汀类降脂药联合血管紧张素Ⅱ受体拮抗剂加强了抑制炎性反应、稳定冠状动脉斑块的作用.