叶酸片联合阿托伐他汀钙片对高同型半胱氨酸血症患者颈总动脉内膜中层厚度影响的长期观察.doc

叶酸片联合阿托伐他汀钙片对高同型半胱氨酸血症患者颈总动脉内膜中层厚度影响的长期观察 ［ ］目的探讨叶酸片联合阿托伐他汀钙片 能否对延缓高同型半胱氨酸血症（HCY）患者颈总动 脉内膜中层增厚产生协同疗效。方法选取高HCY患 者90例，随机分为三组，每组30例。联合组给予叶 酸片和阿托伐他汀钙片治疗，他汀组给予阿托伐他汀 钙片治疗，叶酸组给予叶酸片治疗。观察三组在治疗 前后不同时间点上，颈总动脉内膜中层厚度（IMT）、 血浆HCY、血总胆固醇（TC）、低密度脂蛋白胆固醇 （LDL）、甘油三酯（TG）以及超敏C反应蛋白（hsCRP） 的变化情况。结果在治疗后的各观察时间点上组间 比较，联合组的血浆HCY水平较叶酸组，均无明显降 低（P0.05）;联合组的血TC、LDL、TG水平较他汀组， 均无统计学意义（P0.05）o在治疗后24个月观察时 间点上组间比较：联合组的IMT小于他汀组（P ［关键词］叶酸；阿托伐他汀钙；同型半胱氨酸; 颈动脉；中层内膜厚度 ［ ］R543.4 ［ ］A ［ ］ 2095-0616 (2017) 06-11-05 ［Abstract］ Objective To study the synergistic effect of folic acid tablets in combination with atorvastatin calcium tablet to common carotid artery intima-media thickness (CCA-IMT) of patients with hyperhomocysteinemia. Methods 90 patients with high HCY were randomly divided into three groups, 30 cases in each group.Patients in joint group were treated with folic acid tablets and atorvastatin calcium, patients in statin group were treated with atorvastatin calcium, patients in folic acid group were treated with folic acid tablets.The common carotid artery intima-media thickness (IMT)，plasma HCY, blood total cholesterol (TC)，low-density lipoprotein cholesterol (LDL)， triglycerides (TG) and hypersensitive c-reactive protein (hsCRP) changes of the three groups at different time points before and after treatment were observed. Results After treatment, the comparison of each observation point was as follows： Compared with the folic acid group，there were no significantly decreased on plasma HCY levels of joint group (P0.05) .Compared with the statin group， there were no significantly decreased on blood TC，LDL，TG level of joint group (P〉0.05) .24 months after treatment group， comparison between observation time point was as follows： IMT of joint group was less than that of statin group (P1 group (P 1资料与方法 1.1 一般资料 选取2014年6?12月就诊我院的高HCY患者90 例。入选标准：（1）空腹血浆同型半胱氨酸水平高于 15.0?mol/L； （2）年龄 45?75 岁；（3）高血压；（4） 未服用或未规范服用叶酸和（或）他汀类药物；（5） 经本院伦理委员会审核，全体入选患者签署知情同意 书。排除标准：（1）急性冠脉综合症；（2）急性心力 衰竭；（3）急性脑卒中；（4）急性炎症；（5）明确的 心脑血管