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目的:应用彩色超声、磁共振成像(MRI)技术评价阿托伐他汀与普罗布考联合治疗对脑梗死患者颈动脉粥样硬化(AS)斑块的影响。方法:急性脑梗死存在AS斑块患者120例,随机分为阿托伐他汀(20 mg·d-1)组和阿托伐他汀(20mg·d-1)+普罗布考(500 mg·d-1)组。分别于治疗前、治疗后12和24个月给予彩色多普勒超声、MRI检测颈动脉AS斑块并进行分组分析。结果:阿托伐他汀组治疗后12和24个月时稳定性斑块积分较治疗前增高(P<0.05),不稳定性斑块积分进一步减少(P<0.01);阿托伐他汀+普罗布考组不稳定性斑块积分随着时间进行性降低,各时间点间比较,均差异有统计学意义(P<0.05),且治疗后24个月时不稳定性斑块积分较阿托伐他汀组明显降低。两组治疗后12个月时Ⅱ、Ⅲ级斑块数明显减少,且阿托伐他汀+普罗布考组Ⅲ级斑块数减少更显著;治疗后24个月阿托伐他汀+普罗布考组的Ⅰ级斑块较阿托伐他汀组明显增多,Ⅲ级斑块明显减少。结论:影像学检查显示阿托伐他汀与普罗布考联合治疗具有更强的抗动脉粥样硬化作用,且随着治疗时间的延长表现出更大的优势。
Objective: To evaluate the effect of combination of atorvastatin and probucol on carotid atherosclerosis (AS) plaque in patients with cerebral infarction by color sonography and magnetic resonance imaging (MRI). Methods: A total of 120 AS patients with acute cerebral infarction were randomly divided into atorvastatin (20 mg · d-1) group and atorvastatin (20 mg · d-1) plus probucol 500 mg · d -Group 1. Color Doppler echocardiography was performed before treatment, 12 and 24 months after treatment, and carotid AS plaques were detected by MRI and analyzed by grouping. Results: At 12 and 24 months after treatment, the stability of plaque score in atorvastatin group was higher than that before treatment (P <0.05), and the unstable plaque score was further decreased (P <0.01). Atorvastatin + The score of unstable plaque in the test group decreased progressively with time, and the difference was statistically significant at all time points (P <0.05). At 24 months after treatment, the unstable plaque score was lower than that of Atova The statin group was significantly lower. At 12 months after treatment, the numbers of plaques Ⅱ and Ⅲ decreased significantly, and the numbers of plaques Ⅲ in atorvastatin and probucol decreased more significantly. Atorvastatin + probucol at 24 months after treatment Group Ⅰ plaque than atorvastatin group was significantly increased, Ⅲ plaque was significantly reduced. Conclusions: Imaging studies showed that atorvastatin combined with probucol had a stronger anti-atherosclerotic effect and showed greater advantage with prolonged treatment.