The Effect of Atorvastatin on Carotid Vulnerable Plaques by Contrast-Enhanced Ultrasound and Routine Ultrasound

目的：联合应用超声造影及常规超声观察阿托伐他汀对颈动脉易损斑块的疗效。方法前瞻性研究34例颈动脉斑块患者，规律服用阿托伐他汀20mg/d，配合基础治疗，利用超声造影及常规超声、血脂检查对其进行治疗前后相关指标的评估。结果34例患者共57个斑块，其中观察的易损斑块34个，治疗3个月及6个月后斑块增强强度、曲线下面积明显减少(P＜0.01)。治疗6个月后斑块积分减小，且低或等回声斑块较强回声及混合回声斑块厚度减小更明显，差异有显著统计学意义(P＜0.01)。血脂水平两次测量均较治疗前明显降低(P＜0.01)。结论阿托伐他汀可有效治疗颈动脉易损斑块，超声造影联合常规超声可有效评估颈动脉斑块治疗后的改变，超声造影较常规超声更能早期观察到斑块的变化。Objective To evaluate the effect of atorvastatin on carotid vulnerable plaques by contrast-enhanced ultrasound (CEUS) and routine ultrasound. Methods Prospective study were done on 34 patients with carotid plaques, atorvastatin(20mg/d) was given to the patients together with the treatment of primary diseases. The Effect of the medicine before and after treatment was evaluated by CEUS, routine ultrasound and plasma lipid levels. Results 34 patients totally 57 plaques completed the study, including 34 vulnerable plaques, enhanced intensity and area under curve were obviously decreased after three-month’s or six-month’s treatment (P<0.01). Plaque scores were decreased after six month’s treatment, and the thickness of plaque with iso-echo or low-echo was decreased more signiifcantly than that with strong or mix-echo with statistical difference(P<0.01). The plasma lipid levels were signiifcantly lower after treatment (P<0.01). Conclusion Atorvastatin is effective in the treatment of carotid vulnerable plaque. CEUS and conventional ultrasound are useful tools to assess the changes of carotid plaque after treatment, the changes of the plaque can be observed more earlier by CEUS compared to routine ultrasound.2014年深圳市科技计划项目63-4,122