标题：不同剂量阿托伐他汀对颈动脉斑块患者氧化应激指标的影响

      作者：周华 1，朱浩 1，赵中 1，郑凯 2，许中 3    (南京医科大学附属苏州医院神经内科 1、超声科 2、检验科 3，江苏 苏州 215000）

      卷次： 2017年28卷16期

      【摘要】 目的 探讨不同剂量阿托伐他汀对颈动脉斑块患者氧化应激相关指标的影响。方法 选取 2014年 3月至 2016年 2月在南京医科大学附属苏州医院就诊的颈动脉斑块患者 120例，采用随机数表法将其分为A、B两组，每组 60例。A组患者给予阿托伐他汀 20 mg/d持续治疗 24周，B组患者则给予阿托伐他汀 40 mg/d持续治疗 4周，再改为阿托伐他汀 20 mg/d治疗20周。分别检测患者入组时、治疗4周后、24周后的血清中氧化低密度脂蛋白(ox-LDL)、丙二醛(MDA)水平及颈动脉斑块Crouse积分。结果 两组患者入院时检测血清中ox-LDL及MDA水平比较差异均无统计学意义(P>0.05)；治疗4周、24周后，A组患者中的ox-LDL水平分别为(110.55±17.91) μg/L、(89.91±20.00) μg/L，B组则分别为(101.78±14.53) μg/L、(81.78±13.13) μg/L，差异有显著统计学意义(P<0.01)；A组患者中的MDA水平分别为(6.57±1.29) nmol/L、(5.17±1.42) nmol/L，B组中则分别为(5.87±1.34) nmol/L、(4.42±1.31) nmol/L，差异有显著统计学意义(P<0.01)。两组患者入院时检测颈动脉粥样硬化斑块Crouse积分比较差异无统计学意义(P>0.05)，治疗 24周后A、B两组斑块均明显减小，分别为(2.58±1.32)分、(2.07±1.31)分，差异均有统计学意义(P<0.05)。结论 阿托伐他汀能够减轻颈动脉粥样斑块患者的氧化应激损伤，还可减缓动脉粥样硬化的发展，减轻动脉内膜增厚，且较大剂量阿托伐他汀效果更佳。
      【关键词】 阿托伐他汀；氧化应激；颈动脉斑块；疗效
      【中图分类号】 R543.5 【文献标识码】 A 【文章编号】 1003—6350（2017）16—2593—03

Influence of different initial doses of atorvastatin on oxidative stress indexes in patients with carotid arterialplaques.
ZHOU Hua 1, ZHU Hao 1, ZHAO Zhong 1, ZHENG Kai 2, XU Zhong 3. Department of Neurology 1, Department ofUltrasound 2, Department of Clinical Laboratory 3, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou 215000,Jiangsu, CHINA
【Abstract】 Objective To investigate the influence of different initial doses of atorvastatin on oxidative stressindexes in patients with carotid arterial plaques. Methods A total of 120 patients with carotid arterial plaques, who ad-mitted to our hospital from March 2014 to February 2016, were selected and randomly divided into two groups (Agroup, n=60; B group, n=60). A group was gave atorvastatin 20 mg/d for 24 weeks, but B group was treated for the ini-tial atorvastatin doses of 40 mg/d before 4 weeks, then 20 mg/d for 20 weeks. Two oxidative products: oxidized low den-sity lipoprotein (ox-LDL) and malondialdehyde (MDA), and Crouse score of carotid plaques were detected at admission, 4weeks and 24 weeks after treatment. Results All items had no statistical difference at admission to hospital between twogroups (P>0.05). After therapy for 4 weeks and 24 weeks, the levels of ox-LDL in A group were (110.55±17.91) μg/L,(89.91±20.00) μg/L, and the levels of MDA were (6.57±1.29) nmol/L, (5.17±1.42) nmol/L; while in B group, the levelsof ox-LDL were (101.78±14.53) μg/L, (81.78±13.13) μg/L, and the levels of MDA was (5.87±1.34) nmol/L, (4.42±1.31)nmol/L (P<0.01); oxidative stress indexes reduced after 4 weeks and 24 weeks' treatment in two groups, and the extentof decline in B group was significantly higher than that in A group (P<0.01). There was no significant difference inCrouse score between the two groups at admission. After 24 weeks of treatment, Crouse score in A group was (2.58±1.32), while that in B group was (2.07±1.31). The treatment evaluation of B group was also better than that of A group(P<0.05). Conclusion Atorvastatin calcium Atorvastatin can reduce oxidative stress in patients with acute atheroscle-rotic plaques, and also slow down the development of atherosclerosis and attenuate intimal thickening. The higher dosesof atorvastatin have better effect.
      【Key words】 Atorvastatin; Oxidative stress; Carotid arterial plaques; Influence·论 著·doi:10.3969/j.issn.1003-6350.2017.16.004基金项目：江苏省苏州市科技发展项目（编号：SYSD2012110）