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目的探讨超声评价阿托伐他汀治疗非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)患者的血管结构与功能。方法将102例NAFLD患者随机分为2组各51例,对照组给予减重及饮食干预等基础治疗,治疗组在上述治疗基础上口服阿托伐他汀10mg,每晚1次。另选择51例健康体检者作为正常组。各组行颈动脉及肱动脉超声检测。结果与正常组比较,NAFLD患者的颈动脉血管病变显著(P<0.05)。经过6个月治疗后,治疗组血管的内-中膜厚度(intima-media thickness,IMT)变薄、Crouse积分和面积狭窄率显著改善,与对照组比较差异有统计学意义(P<0.05);2组反应性充血后内径变化率及血流量变化率,治疗组显著高于对照组(P<0.05)。结论阿托伐他汀能显著降低NAFLD患者颈动脉IMT,减少颈动脉斑块面积,改善血流介导的血管内皮舒张功能,对预防心脑血管事件的发生起到一定的作用。
Objective To investigate the vascular structure and function of atorvastatin in the treatment of nonalcoholic fatty liver disease (NAFLD) by ultrasound. Methods A total of 102 patients with NAFLD were randomly divided into two groups (n = 51). The control group was given basic treatment such as weight loss and dietary intervention. The treatment group received atorvastatin 10 mg orally once a night on the basis of the above treatment. Another 51 healthy subjects were selected as the normal group. The carotid artery and brachial artery in each group were examined by ultrasound. Results Compared with the normal group, carotid artery lesions in NAFLD patients were significant (P <0.05). After 6 months of treatment, the intima-media thickness (IMT), Crouse score and stenosis rate of the treatment group were significantly decreased, which were significantly different from the control group (P <0.05) ; The change rate of inner diameter and rate of change of blood flow in the two groups after reactive hyperemia were significantly higher in the treatment group than in the control group (P <0.05). Conclusions Atorvastatin can significantly decrease the carotid IMT, reduce the area of carotid artery plaque in NAFLD patients and improve the vascular endothelial relaxation function mediated by blood flow, which may play an important role in preventing cardiovascular and cerebrovascular events.