·头颈疾病·
超声造影联合常规超声观察阿托伐他汀治疗颈动脉易损斑块的 疗效*
作者:韩燕妮 钟洁愉 黄珍砾 孙德胜 易 黎
所属单位:北京大学深圳医院超声影像科神经内科 (广东 深圳 518036)
PDF摘要
目的 联合应用超声造影及常规超声观察阿托伐他汀对颈动脉易损斑块的疗效。方法 前瞻性研究34例颈动脉斑块患 者,规律服用阿托伐他汀20mg/d,配合基础治疗,利用超声造影及常规超声、血脂检查对其进行治疗前后相关指标 的评估。结果 34例患者共57个斑块,其中观察的易损斑块34个,治疗3个月及6个月后斑块增强强度、曲线下面积 明显减少(P<0.01)。治疗6个月后斑块积分减小,且低或等回声斑块较强回声及混合回声斑块厚度减小更明显,差 异有显著统计学意义(P<0.01)。血脂水平两次测量均较治疗前明显降低(P<0.01)。结论 阿托伐他汀可有效治疗 颈动脉易损斑块,超声造影联合常规超声可有效评估颈动脉斑块治疗后的改变,超声造影较常规超声更能早期观察 到斑块的变化。
Objective To evaluate the effect of atorvastatin on carotid vulnerable plaques by contrast-enhanced ultrasound (CEUS) and routine ultrasound. Methods Prospective study were done on 34 patients with carotid plaques, atorvastatin(20mg/d) was given to the patients together with the treatment of primary diseases. The Effect of the medicine before and after treatment was evaluated by CEUS, routine ultrasound and plasma lipid levels. Results 34 patients totally 57 plaques completed the study, including 34 vulnerable plaques, enhanced intensity and area under curve were obviously decreased after three-month’s or six-month’s treatment (P<0.01). Plaque scores were decreased after six month’s treatment, and the thickness of plaque with iso-echo or low-echo was decreased more significantly than that with strong or mix-echo with statistical difference(P<0.01). The plasma lipid levels were significantly lower after treatment (P<0.01). Conclusion Atorvastatin is effective in the treatment of carotid vulnerable plaque. CEUS and conventional ultrasound are useful tools to assess the changes of carotid plaque after treatment, the changes of the plaque can be observed more earlier by CEUS compared to routine ultrasound.
【关键词】超声;造影剂;颈动脉;斑块;阿托伐他汀
【中图分类号】R540.4+8
【文献标识码】A
【DOI】10.3969/j.issn.1009-3257.2016.06.002
前言
动脉粥样硬化斑块是引起中老年人群缺血性脑卒 中的一个重要危险因素,稳定斑块对于延缓动脉粥样 硬化、预防脑卒中具有重要的意义[1-2]。他汀类降脂 药是目前临床上稳定斑块的主要药物[3-4]。该研究将 超声造影及常规超声作为主要检测方法,观察颈动脉 易损斑块在阿托伐他汀治疗后的变化,并记录终点事 件及不良反应的发生。
罕少疾病杂志
第23卷, 第 2 期
2019年11月
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