林晨志+黄雅玲
[摘要] 意图 讨论叶酸片联合阿托伐他汀钙片能否对推迟高同型半胱氨酸血症（HCY）患者颈总动脉内膜中层增厚发作协同作用。 办法 选取高HCY患者90例，随机分为三组，每组30例。联合组给予叶酸片和阿托伐他汀钙片医治，他汀组给予阿托伐他汀钙片医治，叶酸组给予叶酸片医治。调查三组在医治前后不同时刻点上，颈总动脉内膜中层厚度（IMT）、血浆HCY、血总胆固醇（TC）、低密度脂蛋白胆固醇（LDL）、甘油三酯（TG）以及超敏C反响蛋白（hsCRP）的改变状况。 成果 在医治后的各调查时刻点上组间比较，联合组的血浆HCY水平较叶酸组，均无显着下降（P>0.05）；联合组的血TC、LDL、TG水平较他汀组，均无统计学含义（P>0.05）。在医治后24个月调查时刻点上组间比较：联合组的IMT小于他汀组（P<0.05），联合组的IMT小于叶酸组（P<0.05）。 定论 叶酸联合阿托伐他汀钙片能显着下降高同型半胱氨酸血症患者血同型半胱氨酸水平缓血脂水平，联合医治削减颈总动脉内膜中层厚度的远期作用更明显，更有利于推迟动脉粥样硬化。
[关键词] 叶酸；阿托伐他汀钙；同型半胱氨酸；颈动脉；中层内膜厚度
[中图分类号] R543.4 [文献标识码] A [文章编号] 2095-0616（2017）06-11-05
[Abstract] Objective To study the synergistic effect of folic acid tablets in combination with atorvastatin calcium tablet to common carotid artery intima-media thickness（CCA-IMT） of patients with hyperhomocysteinemia. Methods 90 patients with high HCY were randomly divided into three groups，30 cases in each group.Patients in joint group were treated with folic acid tablets and atorvastatin calcium，patients in statin group were treated with atorvastatin calcium， patients in folic acid group were treated with folic acid tablets.The common carotid artery intima-media thickness （IMT），plasma HCY，blood total cholesterol（TC），low-density lipoprotein cholesterol （LDL），triglycerides （TG） and hypersensitive c-reactive protein （hsCRP） changes of the three groups at different time points before and after treatment were observed. Results After treatment，the comparison of each observation point was as follows：Compared with the folic acid group，there were no significantly decreased on plasma HCY levels of joint group（P>0.05）.Compared with the statin group， there were no significantly decreased on blood TC，LDL，TG level of joint group（P>0.05）.24 months after treatment group，comparison between observation time point was as follows：IMT of joint group was less than that of statin group（P<0.05），the IMT of joint group was less than that of folic acid group（P<0.05）. Conclusion Folic acid tablets in combination with atorvastatin calcium tablet can obviously reduce homocysteine levels in patients with blood homocysteine levels and blood lipid levels.Combination therapy to reduce the forward of the common carotid artery intima-media thickness effect is more prominent，and it is more conducive to postpone sclerosis of arterial congee appearance.
[Key words] Folic acid；Atorvastatin calcium；Homocysteine；Carotid artery；Middle membrane thickness
隨着社会的开展，缺血性心脏病及脑血管疾病已成为全球的榜首、二位的逝世原因，而缺血性心
脏病及脑血管疾病一起的病理根底是动脉粥样硬化。动脉粥样硬化构成的病理生理进程是脂质成分（以胆固醇为主）在动脉壁的堆积。研讨显现，血清总胆固醇水平与动脉粥样硬化的发作、开展密切相关[1]。高同型半胱氨酸（HCY）血症可引起血管内皮功用危害[2]，其已成为继高血压高血脂糖尿病吸烟肥壮等要素之后，动脉粥样硬化的又一独立风险因子[3]。高胆固醇血症和高同型半胱氨酸血症叠加将加快全身动脉粥样硬化的发作及开展。作为全身动脉的组成部分，颈动脉粥样硬化程度对全身动脉病变发作有着重要的参考价值，并与心脑血管疾病的发作有着很强的相关性[4]，特别颈动脉内膜中层厚度（IMT）是反映动脉硬化的灵敏特异性目标。颈动脉IMT可以独立猜测心脑血管病事情[5]。因而，颈动脉彩超作为一种无创性的查看，适用于检测颈动脉IMT，而颈总动脉IMT因为简单取得而且可重复性高，临床上常用的调查目标。经过丈量医治前后颈总动脉IMT改变，断定治作用果。本研讨旨在经过调查高HCY患者医治前后血浆HCY、血脂水平缓颈总动脉IMT的改变，了解叶酸片联合阿托伐他汀钙片能否对推迟或反转高HCY患者颈总动脉IMT抗动脉粥样硬化发作协同作用。现报导如下。
根据您访问的内容，您可能还对以下内容感兴趣，希望对您有帮助：