Statin therapy increases carotid plaque echogenicity in hypercholesterolemic patients
Statin therapy increases carotid plaque echogenicity in hypercholesterolemic patients
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DOI：
10.1016/j.ultrasmedbio.2008.01.019
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发表时间：
2008-09-01
影响因子：
2.9
通讯作者：
Kitagawa, Kazuo
中科院分区：
文献类型：
--
作者：
Yamagami, Hiroshi;Sakaguchi, Manabu;Kitagawa, Kazuo
通过药物干预稳定颈动脉斑块是预防缺血性卒中的一种有前途的策略。在这项研究中，我们研究了12个月的他汀类药物治疗对颈动脉斑块回声的影响。本研究包括81例颈动脉粥样硬化斑块的高胆固醇血症患者。通过超声背向散射积分分析评价每例患者最大斑块的回声。所有患者均接受饮食调整。40例患者根据每位主治医生的选择接受辛伐他汀（10 mg/d，n = 24）或阿托伐他汀（5 mg/d，n = 16）治疗。在12个月的随访期内，通过测量斑块厚度和回声来监测颈动脉斑块。检测血清超敏C反应蛋白（hs-CRP）、白细胞介素（IL）-6、IL-18水平。他汀类药物治疗12个月后，总胆固醇、甘油三酯、hs-CRP和IL-18显著降低。IL-6水平变化不显著。他汀类药物治疗后，颈动脉斑块回声增强，斑块厚度减少。在41例未接受他汀类药物治疗的患者中，颈动脉斑块回声、斑块厚度和血清炎症标志物水平均未发生显著改变。我们的研究结果表明，他汀类药物治疗高胆固醇血症患者12个月增加颈动脉斑块回声和减少斑块厚度，除了降低血脂和炎症标志物的血清水平。
Stabilization of carotid artery plaques by pharmacologic intervention is a promising strategy for the prevention of ischemic stroke. In this study, we examined the effect of 12 months of statin therapy on carotid plaque echogenicity. This study included 81 hypercholesterolemic patients with carotid atherosclerotic plaques. Echogenicity of the largest plaque in each patient was evaluated by ultrasound with integrated backscatter analysis. All patients underwent dietary modification. Forty patients were treated with simvastatin (10 mg/day, n = 24) or atorvastatin (5 mg/day, n = 16) according to the choice by each attending physician. Carotid plaques were monitored by measuring plaque thickness and echogenicity during a 12-month follow-up period. Levels of serum high-sensitivity CRP (hs-CRP), interleukin (IL)-6 and IL-18 were determined in all patients. Total cholesterol, triglyceride, hs-CRP and IL-18 were significantly decreased after 12 months of statin therapy. The change in IL-6 level was not significant. Significant increases in echogenicity of carotid plaques and decreases in plaque thickness were noted after statin therapy. In the 41 patients without statin therapy, carotid plaque echogenicity, plaque thickness and serum levels of inflammatory markers were not significantly altered. Our results suggest that statin therapy in hypercholesterolemic patients for 12 months increases carotid plaque echogenicity and decreases plaque thickness, in addition to lowering serum levels of lipids and inflammatory markers.