普羅布考治療頸動(dòng)脈易損斑塊的臨床研究
發(fā)布時(shí)間：2018-09-01 19:40
【摘要】：目的比較實(shí)驗(yàn)組和對(duì)照組治療前后頸動(dòng)脈易損斑塊檢出率和頸動(dòng)脈內(nèi)膜中層厚度,以及治療期間缺血性卒中事件的發(fā)生率,從而評(píng)價(jià)普羅布考治療頸動(dòng)脈易損斑塊的臨床效果。 方法入選對(duì)象為我院2012年10月至2013年6月住院和門診患者100例,均經(jīng)彩色超聲檢查明確存在頸動(dòng)脈易損粥樣斑塊。 入選排除標(biāo)準(zhǔn)：排除腫瘤、肝臟病變、感染性疾病,近期無(wú)重大外傷、手術(shù)史。100例患者(其中男性79例,女性21例,年齡41歲～75歲)隨機(jī)分為試驗(yàn)組(n=50)和對(duì)照組(n=50)。 兩組患者基礎(chǔ)治療基本相同,均口服阿司匹林腸溶片100mg,每日1次(拜耳醫(yī)藥保健有限公司),阿托伐他汀鈣片20mg,每日1次(輝瑞制藥有限公司),入選對(duì)象根據(jù)病情需要予抗高血壓藥、降血糖藥等治療。 試驗(yàn)組在常規(guī)治療基礎(chǔ)上加服普羅布考250mg,2次/日(山東齊魯制藥有限公司,每片125mg)；服藥治療6個(gè)月。治療期間不服用同類或其他調(diào)脂藥物及抗氧化劑等對(duì)動(dòng)脈粥樣硬化有影響的藥物。觀察治療前及治療后3個(gè)月和6個(gè)月后實(shí)驗(yàn)組和對(duì)照組患者原有斑塊的厚度變化和頸動(dòng)脈易損斑塊檢出率以及治療過(guò)程中兩組缺血性卒中的發(fā)病率。用藥前后及組間比較用配對(duì)t檢驗(yàn),計(jì)數(shù)資料比較用x2檢驗(yàn)。P0.05為差異有統(tǒng)計(jì)學(xué)意義。 實(shí)驗(yàn)結(jié)果兩組患者治療前頸動(dòng)脈易損斑塊檢出率一致,均為100%；頸動(dòng)脈內(nèi)膜中層厚度治療前比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。 治療3個(gè)月后：實(shí)驗(yàn)組頸動(dòng)脈易損斑塊檢出率由治療前100%降至42%,對(duì)照組頸動(dòng)脈易損斑塊檢出率由治療前100%降至62%。實(shí)驗(yàn)組的頸動(dòng)脈易損斑塊轉(zhuǎn)為穩(wěn)定斑塊的病例明顯高于對(duì)照組。X2=4.00,P0.05,有統(tǒng)計(jì)學(xué)差異。實(shí)驗(yàn)組頸動(dòng)脈易損斑塊IMT治療前為3.34±0.42mm,治療后為2.07±0.38mm,對(duì)照組頸動(dòng)脈易損斑塊IMT治療前3.15±0.50mm,治療后為2.41±0.32mm。治療后兩組對(duì)比P0.05,有統(tǒng)計(jì)學(xué)差異。 治療6個(gè)月后：實(shí)驗(yàn)組頸動(dòng)脈易損斑塊檢出率由治療前100%降至6%,對(duì)照組頸動(dòng)脈易損斑塊檢出率由治療前100%降至20%。實(shí)驗(yàn)組的頸動(dòng)脈易損斑塊轉(zhuǎn)為穩(wěn)定斑塊的病例明顯高于對(duì)照組。X2=4.33,P0.05,有統(tǒng)計(jì)學(xué)差異。兩組患者頸動(dòng)脈IMT比較,實(shí)驗(yàn)組頸動(dòng)脈易損斑塊IMT治療前為3.3.4±0.42mm,治療后為1.29±0.51mm,對(duì)照組頸動(dòng)脈易損斑塊IMT治療前3.15±0.50mm,治療后為1.63±0.37mmm。治療前兩組對(duì)比P0.05,無(wú)統(tǒng)計(jì)學(xué)差異；治療后兩組對(duì)比P0.05,有統(tǒng)計(jì)學(xué)差異。 結(jié)論本試驗(yàn)證實(shí)了普羅布考可抑制氧化應(yīng)激,從源頭阻斷動(dòng)脈粥樣硬化的發(fā)生,穩(wěn)定易損斑塊,并減小斑塊體積,抑制斑塊進(jìn)展,阻止斑塊的破裂及事件的發(fā)生。在易損斑塊的治療中,抗血小板治療和他汀類藥物治療作用值得肯定。
[Abstract]:Objective to evaluate the clinical efficacy of probucol in the treatment of carotid artery vulnerable plaque by comparing the detection rate of carotid artery vulnerable plaque, carotid intima-media thickness and the incidence of ischemic stroke events between experimental group and control group before and after treatment. Methods from October 2012 to June 2013, 100 inpatients and outpatients were enrolled in our hospital. The presence of carotid atherosclerotic plaques was confirmed by color ultrasound. Exclusion criteria: exclusion of tumors, liver lesions, infectious diseases, no recent major trauma, and surgical history of 100 patients (male 79, female 21, age 41 to 75) were randomly divided into the trial group (n = 50) and the control group (n = 50). The basic treatment of the two groups was basically the same. All patients were treated with 100 mg aspirin enteric-coated tablets once a day (Bayer Medical Care Co., Ltd), Atto vastatin calcium tablets 20 mg and once a day (Pfizer Pharmaceutical Co., Ltd.). The subjects were given antihypertensive drugs and hypoglycemic drugs according to their condition. The experimental group was given probucol 250 mg / d (Shandong Qilu Pharmaceutical Co., Ltd, each tablet 125mg) on the basis of routine treatment, and treated with probucol for 6 months. Do not take the same or other lipid-regulating drugs and antioxidants that have an effect on atherosclerosis during treatment. The changes of plaque thickness and the detection rate of carotid vulnerable plaque were observed before treatment, 3 months and 6 months after treatment, and the incidence of ischemic stroke in the two groups during the treatment. Before and after the use of drugs and the comparison between groups with paired t test, count data comparison using x2 test. P0.05 as the difference was statistically significant. The results showed that the detection rate of carotid vulnerable plaque was the same in the two groups before treatment, which was 100%. There was no significant difference in carotid intima-media thickness before treatment (P0.05). After 3 months of treatment, the detection rate of vulnerable plaque in carotid artery decreased from 100% to 42% in the experimental group and from 100% to 62% in the control group. The cases with stable plaque of carotid artery in the experimental group were significantly higher than those in the control group (P 0.05). The IMT of vulnerable plaque in experimental group was 3.34 鹵0.42mm before treatment and 2.07 鹵0.38mm after treatment. In control group, IMT was 3.15 鹵0.50mm before treatment and 2.41 鹵0.32mm. After treatment, there was a statistical difference between the two groups (P 0.05). After 6 months of treatment, the detection rate of vulnerable plaque in carotid artery decreased from 100% to 6% in the experimental group and from 100% to 20% in the control group. The cases with stable plaque in the carotid artery in the experimental group were significantly higher than those in the control group (P 0.05). IMT of carotid artery was 3.3.4 鹵0.42mm before treatment and 1.29 鹵0.51mm after treatment in experimental group, and 3.15 鹵0.50mm before IMT treatment and 1.63 鹵0.37mm after treatment in control group. There was no statistical difference between the two groups before treatment, and there was statistical difference between the two groups after treatment. Conclusion Probucol can inhibit oxidative stress, block atherosclerosis from the source, stabilize vulnerable plaque, reduce plaque volume, inhibit plaque progression, and prevent plaque rupture and events. In the treatment of vulnerable plaque, anti-platelet therapy and statins are worthy of recognition.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R743.3
本文編號(hào)：2218152
[Abstract]:Objective to evaluate the clinical efficacy of probucol in the treatment of carotid artery vulnerable plaque by comparing the detection rate of carotid artery vulnerable plaque, carotid intima-media thickness and the incidence of ischemic stroke events between experimental group and control group before and after treatment. Methods from October 2012 to June 2013, 100 inpatients and outpatients were enrolled in our hospital. The presence of carotid atherosclerotic plaques was confirmed by color ultrasound. Exclusion criteria: exclusion of tumors, liver lesions, infectious diseases, no recent major trauma, and surgical history of 100 patients (male 79, female 21, age 41 to 75) were randomly divided into the trial group (n = 50) and the control group (n = 50). The basic treatment of the two groups was basically the same. All patients were treated with 100 mg aspirin enteric-coated tablets once a day (Bayer Medical Care Co., Ltd), Atto vastatin calcium tablets 20 mg and once a day (Pfizer Pharmaceutical Co., Ltd.). The subjects were given antihypertensive drugs and hypoglycemic drugs according to their condition. The experimental group was given probucol 250 mg / d (Shandong Qilu Pharmaceutical Co., Ltd, each tablet 125mg) on the basis of routine treatment, and treated with probucol for 6 months. Do not take the same or other lipid-regulating drugs and antioxidants that have an effect on atherosclerosis during treatment. The changes of plaque thickness and the detection rate of carotid vulnerable plaque were observed before treatment, 3 months and 6 months after treatment, and the incidence of ischemic stroke in the two groups during the treatment. Before and after the use of drugs and the comparison between groups with paired t test, count data comparison using x2 test. P0.05 as the difference was statistically significant. The results showed that the detection rate of carotid vulnerable plaque was the same in the two groups before treatment, which was 100%. There was no significant difference in carotid intima-media thickness before treatment (P0.05). After 3 months of treatment, the detection rate of vulnerable plaque in carotid artery decreased from 100% to 42% in the experimental group and from 100% to 62% in the control group. The cases with stable plaque of carotid artery in the experimental group were significantly higher than those in the control group (P 0.05). The IMT of vulnerable plaque in experimental group was 3.34 鹵0.42mm before treatment and 2.07 鹵0.38mm after treatment. In control group, IMT was 3.15 鹵0.50mm before treatment and 2.41 鹵0.32mm. After treatment, there was a statistical difference between the two groups (P 0.05). After 6 months of treatment, the detection rate of vulnerable plaque in carotid artery decreased from 100% to 6% in the experimental group and from 100% to 20% in the control group. The cases with stable plaque in the carotid artery in the experimental group were significantly higher than those in the control group (P 0.05). IMT of carotid artery was 3.3.4 鹵0.42mm before treatment and 1.29 鹵0.51mm after treatment in experimental group, and 3.15 鹵0.50mm before IMT treatment and 1.63 鹵0.37mm after treatment in control group. There was no statistical difference between the two groups before treatment, and there was statistical difference between the two groups after treatment. Conclusion Probucol can inhibit oxidative stress, block atherosclerosis from the source, stabilize vulnerable plaque, reduce plaque volume, inhibit plaque progression, and prevent plaque rupture and events. In the treatment of vulnerable plaque, anti-platelet therapy and statins are worthy of recognition.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R743.3
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