摘要目的 观察降脂药物辛伐他汀对老年下肢动脉硬化患者的作用. 方法 回顾性分析343例老年下肢动脉硬化患者的临床资料,均经B超和(或)数字减影血管造影证实,选择其中128例资料完整的病例为研究对象.其中64为伴有间歇性跛行的下肢动脉硬化患者,且接受降脂治疗(治疗组),64例为无临床症状下肢动脉硬化患者(无症状组).64例无下肢动脉硬化患者作为对照组,比较3组血脂、C反应蛋白(CRP)的差异,及服用辛伐他汀18个月后血脂、CRP水平的变化.同时应用彩色多普勒超声比较下肢动脉斑块的变化. 结果 治疗组治疗前总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、CRP水平分别为(6.3±1.7)mmol/L、(3.8±1.3)mmol/L和(5.74±1.5)mmol/L,对照组分别为(5.2±1.3)mmol/L、(2.1±1.3)mmol/L和(3.3±1.4)mmol/L,二者相比较差异有统计学意义(均为P＜0.05),治疗组经辛伐他汀治疗18个月后TC、LDL-C、CRP水平比较,[分别为(5.3±1.2)mmol/L、(2.9±1.6)mmol/L和(4.6±1.1)mmol/L]与治疗前差异有统计学意义(P＜0.05).多普勒超声显示,治疗组治疗18个月后斑块大小自身比较,差异无统计学意义(P＞0.05),但临床症状减轻或消失,发生跛行症状的行走距离延长[治疗前(31.7±22.8)m,治疗后(41.2±26.7)m,P＜0.05].无症状组18个月后自身斑块大小比较,差异有统计学意义(P＜O.05),且LDL-C及CRP水平升高. 结论 下肢动脉硬化患者进行降脂治疗可以延缓动脉硬化进展,CRP可作为病情发展及监测的早期指标.

abstractsObjective To evaluate the therapeutic effects of simvastatin in elderly patients with lower extremity atherosclerosis disease. Methods One hundred and twenty-eight patients were divided into 2 groups:64 cases with intermittent claudication(group l)and 64 asymptomatic cases with intermittent claudication(group 2).Sixty-four normal cases were served as control group(group 3).THe patients of group l were given simvastatin for 18 months.The differences in levels of blood lipids and C-reactive protein(CRP),the size of plaque and the changes between pre-and post-treatments were observed among three groups. Results TC,LDL-C and CRP levels were significantly higher in group l than those in group 3 before the treatment[(6.3±1.7)mmol/L vs. (5.2±1.3)mmol/L,(3.8±1.3)mmol/Lυs.(2.1±1.3)mmol/L,(5.7±1.5)mmol/Lυs.(3.3±1.4)mmol/L,respectively,all P＜0.05].TC,LDL-C and CRP levels significantly decreased in group0.053.There were no differences in plaque size and in plaque number in group 1 between pre-and post -treatments(both P＞0.05),but the clinieal symptoms were relieved or disappeared.There were significant differences in plaque size,blood lipid level and CRP level in group 2 after 18 months treatment(all P＜0.05). Conclusions Simvastatin can delay the development of artherioscIerosis in the patients with lower extremity atherosclerosis disease.CRP can be used as an early index of disease development and illness monitoring.