CT血管造影对阿托伐他汀治疗冠状动脉粥样硬化斑块效果的监测作用

目的 探讨冠状动脉CT血管造影在阿托伐他汀治疗冠状动脉硬化斑块效果监测中的作用.方法 选取经冠状动脉CT血管成像证实管腔狭窄程度＜50％的高胆固醇血症患者80例,完全随机分为观察组和对照组,各40例.观察组口服阿托伐他汀（10 mg/次,1次/d）和阿司匹林治疗,对照组给予单纯阿司匹林治疗.检测治疗前及治疗12个月后血脂和冠状动脉CT血管成像,观察2组患者治疗前后冠状动脉粥样硬化斑块的变化.结果 ①治疗后,2组总胆固醇、低密度脂蛋白胆固醇、三酰甘油及高密度脂蛋白胆固醇均较治疗前改善,2组治疗前后血脂水平比较差异均有统计学意义（均P＜0.05）.治疗后,观察组与对照组各项血脂水平差异无统计学意义（P＞0.05）.②治疗12个月后,2组非钙化斑块、钙化斑块和混合斑块引起的冠状动脉管腔狭窄程度低于治疗前,治疗前后差异均有统计学意义（P＜0.05）;观察组治疗后非钙化斑块、钙化斑块和混合斑块管腔狭窄程度与对照组比较差异均有统计学意义（均P＜0.05）.③观察组非钙化斑块、钙化斑块和混合斑块平均容积分别从治疗前的（17±6）、（24±5）、（42±12）mm3下降至治疗后的（13±4）、（20±7）、（32±10）mm3,治疗前后差异均有统计学意义（均P＜0.05）.对照组非钙化斑块、钙化斑块和混合斑块平均容积分别从治疗前的（16±4）、（26±4）、（41±13）mm3下降至治疗后的（13±6）、（23±7）、（36 ±8）mm3,治疗前后非钙化斑块、混合斑块平均容积的差异有统计学意义（P＜0.05）,钙化斑块平均容积差异无统计学意义（P＞0.05）.治疗后,观察组与对照组非钙化斑块、钙化斑块和混合斑块的平均容积差异均有统计学意义（均P＜0.05）.结论 冠状动脉CT血管造影能有效监测阿托伐他汀治疗冠状动脉粥样硬化斑块的效果.

CT monitoring the efficacy of atorvastatin treating coronary atherosclerotic plaque

Objective To observe the effect of atorvastatin treating atherosclerotic plaque using coronary computed tomography angiography （CTA）.Methods Eighty patients with coronary CTA demonstrating 〈 50% lumen stenosis were enrolled.They were randomly allocated into observation group （n =40） and control group （n =40）.Patients in observation group received atorvastatin 10 mg,once daily and aspirin treatment; patients in control group only received aspirin treatment.After 12 months,lipid was detected and all the patients received the coronary CTA,the changes of atherosclerotic plaque and lumen stenosis were observed.Results In the observation and control group,total cholesterol,low-density lipoprotein cholesterol and triglyceride were decreased obviously （P 〈 0.05）,while no statistical significance was observed between two groups after treatment （P 〉 0.05）.In the treatment group,the average volume of non-calcified plaque,calcified plaque and mixed plaque were reduced from （17 ±6）mm3,（24 ±5）mm3,（42 ±12）mm3 to （13 ±4）mm3,（20 ±7）mm3,（32 ± 10）mm3 ; the differences between pre-treatment and post-treatment were statistical significant （all P 〈 0.05）.Conclusion Atorvastatin can reduce atherosclerotic plaque and decrease lumen stenosis; coronary CTA can observe the effect of atorvastatin on atherosclerotic plaque.