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目的 观察强化降脂治疗对冠状动脉粥样斑块的影响,比较不同他汀类药物作用的差别.方法 将74例经双源螺旋CT血管造影确诊的冠状动脉粥样斑块患者,随机分为治疗组和对照组,各37例,分别给予普伐他汀20 mg/d和洛伐他汀20 mg/d口服,12个月后复查冠脉CTA观察斑块变化.结果 治疗组总胆固醇、低密度胆固醇治疗后分别下降31.5%、42.6%,与对照组相比差异有统计学意义(P<0.05).两组患者共发现175个粥样斑块,导致126支冠状动脉不同程度狭窄.治疗组脂质斑块、纤维斑块、混合斑块引起的冠脉狭窄分别减少23.7%、15.4%、12.5%,较对照组下降更明显(P0.05).结论 普伐他汀可有效降低胆固醇,能明显逆转冠脉粥样斑块,降低冠脉狭窄程度.“,”Objective To observe the influence of intensified blood lipid reduction on coronary artery plaque,and compare the differences between pravastatin and lovastatin.Methods Seventy-four cases of coronary artery atheromatous plaque examined with dual source spiral CT were randomly allocated into two groups:treatment group and control group.Treatment group given pravastatin 20 mg/d and control group given lovastatin 20 mg/d.The changes of plaque and blood lipid were observed after 12 months.Results The TC and LDL-C of the treatment groups induced 31.5% and 42.6%.And the treatment group induced greater than the control gruop(P<0.05).175 plaques observed in 126 coronary artery branches.The coronary artery stenosis caused by all plaques have different degrees of descent after the treatment.The descent rate of the treatment group was 13.7% in lipoid plaques(P<0.01),15.4% in fibrous plaques(P<0.05),12.5% in mixed plaques(P0.05).The treatment group induced greater(P<0.05).Conclusion Pravastatin can reduce blood lipid markly,reverse and stabilize the coronary artery plaque.