通心络治疗颈动脉粥样硬化30例临床剖析.docVIP

通心络治疗颈动脉粥样硬化30例临床剖析 　　中图分类号：R543.4 　　文献标识码： A 　　文章编号： 1672-3783(2008)-7-0006-03 　　 　　【摘 要】目的 探讨通心络是否对颈动脉粥样硬化的发展有抑制作用。方法 30例诊断“脑供血不足”的门诊病人，经Hpsonos5500型超声仪，证实颈动脉内膜有硬化改变或硬化斑块，随机进入通心络治疗或对照组。治疗组投给通心络胶囊4粒，3/d，对照组投给阿斯匹林75mg/d、舒降之20mg/d,均连服180天。试验前后测定血清氧化低密度脂蛋白（OX-LDL）、单核细胞趋化因子（MCP-1）水平的变化，彩超检查颈动脉粥样硬化情况，观察内-中膜厚度（IMT）、内皮表面情况及硬化斑的变化。结果 (1)服药半年后两组血浆OX-LDL及MCP-1含量均显著下降（p0.05）。治疗180天后，两组水平均明显下降，但对照组下降程度较试验组更明显，组间差异具有显著性（p0.05）。结论 两组干预对颈动脉粥样硬化的发展均有一定影响，其作用程度相近。病人对通心络胶囊的耐受良好，有高度依从性。 　　【关键词】 颈动脉粥样硬化 IMT OX-LDL MCP-1 　　 　　A Clinical-Contral Intervention Study On The Patents 　　With Carotid Atheosclerosis 　　Liu Deng-qi,WU Juan，FU Zhao-Hui 　　The Third People’s Hospitalof Chongqing, Chongqing 400014, China 　　【Abstract】Objective To investigate the intervention effect on the patients with carotid atherosclerosis.Methods 30 patients with carotid atherosclerosis complicated by cerebral blood supply unsatisfaction , 30 of whom,as the test group, were treated with Tongxinluo (dose:4# tid ) and the rest, as the control group,were given Simvastatin (dose: 20mg qd ) and aspirin (dose:75mg qd ) for treatment 6 months. Before and after the treatment , determine the IMT of carotid artery, measure OX-LDL and MCP-1 in serum .Compare the changes between the different treat groups after 6 ?month treatment.Results (1)The levels of serum OX-LDL and MCP-1, either in the patients of the test group, or of the control group were decreased significantly (p0.05) .After 6 months treating , levels of serum OX-LDL and MCP-1of the control group were lower significantly than those of the test group(p0.05).Conclusion This study revealed that the therapies both of the test group and the control group were effective in treating carotid atherosclerosis. The efficiency of the two therapies were nearly equal. 　　【Key words】Carotid atherosclerosis; Intima-media thickness(IMT); Oxidized low density lipoprotein(OX-LDL); Monocyte chemoattractant protein-1(MCP-1) 　　 　　动脉粥样硬化（AS）是危害人类健康的一种重要疾病，颈动脉粥样硬化是缺血性脑血管病的重