【作者】 贾节； 赵萍； 田媛媛； 马培； 邓玲灵； 梁诗莹；

【Author】 JIA Jie;ZHAO Ping;TIAN Yuan-yuan;MA Pei;DENG Ling-ling;LIANG Shi-ying;Guangzhou University of Chinese Medicine;Department of Medical Technology,First Affiliated Hospital of Guangzhou University of Chinese Medicine;

【机构】 广州中医药大学； 广州中医药大学第一附属医院超声科；

【摘要】 目的:运用超声造影技术定量检测动脉粥样硬化斑块外膜滋养血管增强强度,探讨温胆片调控动脉外膜滋养血管的价值。方法:48例动脉粥样硬化斑块痰浊证患者,随机分为温胆片组与阿托伐他汀组,口服温胆片(3g/d)、阿托伐他汀钙片(40mg/d),疗程3个月。治疗前后分别行超声造影及血清学检查,测定颈动脉内-中膜厚度(IMT)、斑块厚度、面积、造影增强强度(EI)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)值,分析治疗前后和组间的诸参数变化。结果:3个月后,温胆片组斑块厚度降低、斑块面积减小、EI减低,TG、TC水平下降,HDL-C指标上升,均具有统计学差异(P<0.05)。阿托伐他汀组IMT减小,斑块厚度降低、面积减小、EI减低,TG、TC、LDL-C水平下降,均具有统计学差异(P<0.05)。两组治疗后斑块回声增强,各指标间未见明显统计学差异。结论:超声造影可以直接呈现外膜滋养血管,量化评价斑块新生血管;温胆片可以增加动脉粥样硬化斑块稳定性,其疗效与他汀类调脂药效果相似。更多还原

【Abstract】 Objectives:To serially investigate the relationship between adventitial vasa vasorum(W) proliferation and plaque progression in carotid plaque,and the effects of Wendan Capsule on adventitial W and atherosclerotic plaque as assessed by contrast-enhanced ultrasound(CEUS) imaging.Methods:Following the imaging of carotid arteries by CEUS,48 patients with carotid atherosclerosis were randomized into Wendan Capsule group(3g/d) or atorvastatin group(40mg/day) for 12 weeks.At week 12,CEUS’ were repeated.Each individual was measured the carotid intima-media thickness(IMT),plaque thickness,plaque area,the density of the adventitial VV network,TG,TC,LDL-C,and HDL-C.Results:Contrast-enhanced ultrasound was effective for detection of adventitial vasa vasorum in atherosclerotic plaques.CEUS demonstrated a significantly decreased plaque thickness,plaque area,EI,TG,TC and increased HDL-C,was significantly greater in the Wendan Capsule group than before(P<0.05).Group atorvastatin had significantly decreased IMT,plaque thickness,plaque area,EI,TG,TC and LDL-C(P<0.05),while the difference of these two groups had no significance.Conclusions:By providing the direct visualization of adventitial W,CEUS is capable of depicting the new surrogate markers of atherosclerotic plaque.Wendan Capsule significantly inhibites the development of adventitial W and progression of atherosclerotic plaque.更多还原