[1]毕静婷 姚泽旭 余超 邢磊.他汀类药物治疗后富含脂质斑块特征及炎症指标变化[J].心血管病学进展,2025,(5):451.[doi:10.16806/j.cnki.issn.1004-3934.2025.05.016]
　BI Jingting,YAO Zexu,YU Chao,et al.Characteristics of Lipid-Rich Plaques and Changes of Inflammatory Markers After Statin Therapy[J].Advances in Cardiovascular Diseases,2025,(5):451.[doi:10.16806/j.cnki.issn.1004-3934.2025.05.016]
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他汀类药物治疗后富含脂质斑块特征及炎症指标变化()

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2025年5期
页码:
451
栏目:
论著
出版日期:
2025-05-25

文章信息/Info

Title:
Characteristics of Lipid-Rich Plaques and Changes of Inflammatory Markers After Statin Therapy
作者:
毕静婷 姚泽旭 余超 邢磊
(哈尔滨医科大学附属第二医院心血管内科 教育部心肌缺血重点实验室,黑龙江 哈尔滨 150081)
Author(s):
BI Jingting; YAO Zexu; YU Chao; XING Lei
(Department of Cardiology,The Second Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia,Chinese Ministry of Education,Harbin 150081, Heilongjiang,China)
关键词:
富含脂质斑块; 炎症因子; 光学相干断层成像; 血管内超声; 他汀类药物
Keywords:
Lipid-rich plaque; Inflammatory factor; Optical coherence tomography; Intravascular ultrasound; Statins
DOI:
10.16806/j.cnki.issn.1004-3934.2025.05.016
摘要:
目的 评价冠状动脉粥样硬化性心脏病患者服用他汀类药物后斑块特征和炎症指标变化。方法 77例 规律服用他汀类药物患者，应用光学相干断层成像（OCT）和血管内超声检测筛选出77个富含脂质斑块（LRP）进行分析和相关测量。同时检测患者的血清炎症因子超敏C反应蛋白（hs-CRP）、白细胞介素17（IL-17）和结缔组织生长因子浓度，结合患者影像学指标和血清炎症因子变化进行相关性分析。结果 OCT影像学定量分析结果显示，在基线、6个月及12个月随访中，可观察到LRP的纤维帽厚度增厚（P＜0.001），最大脂质角度减小（P=0.037）；对77个LRP的OCT定性分析发现，在3个时间点薄纤维帽富含脂质斑块减少（P＜0.001）；血清炎症因子分析结果显示，在3个时间点hs-CRP分别为（10.83±33.63）mg/L、（1.16±1.04）mg/L和（1.35±1.21）mg/L（P=0.002）；3个时间点IL-17分别为（17.90±14.80）ng/L、（15.40±9.20）ng/L和（11.60±6.80）ng/L（P=0.002）。相关性分析显示，在12个月随访时间内，hs-CRP、IL-17及结缔组织生长因子的变化未显示出与斑块特征稳定性改变存在相关性。结论 长期服用他汀类药物不仅显著降低低密度脂蛋白胆固醇和载脂蛋白B的血浆水平，通过腔内影像学技术可观察到斑块稳定性增加，同时可观察到患者相关炎症因子指标下降，可能与他汀类药物在动脉粥样硬化中的抗炎作用相关。
Abstract:
Objective To evaluate characteristics of lipid-rich plaques(LRP) and changes of inflammatory markers after sta tin therapy in patients with coronary atherosclerotic disease. Methods 77 patients regularly taking statins were screened for LRP using optical coherence tomography(OCT) and intravascular ultrasound for analysis and related measurements. Simultaneously detect the serum inflammatory factors high-sensitivity C reactive protein(hs-CRP),interleukin-17(IL-17),and connective tissue growth factor concentrations of patients,and conduct correlation analysis with changes in patient imaging indicators and serum inflammatory factors. Results The quantitative analysis results of OCT imaging showed that at baseline,6-month and 12-month follow-up,an increase in fiber cap thickness(P＜0.001) and a decrease in maximum lipid angle(P=0.037) were observed in LRP. Qualitative analysis of OCT on 77 LRPs revealed a decrease in LRP in the thin fibrous cap at three time points(P＜0.001). The analysis of serum inflammatory factors showed that the hs-CRP at three time points were (10.83±33.63)mg/L,(1.16±1.04)mg/L,and (1.35±1.21)mg/L,respectively(P=0.002). The IL-17 levels at three time points were (17.90±14.80)ng/L,(15.40±9.20)ng/L,and (11.60±6.80)ng/L,respectively(P=0.002). Correlation analysis showed that during the 12-month follow-up period,changes in hs-CRP,IL-17,and connective tissue growth factor did not show any correlation with changes in plaque characteristic stability. Conclusion Long-term use of statins not only significantly reduces the plasma levels of low-density lipoprotein cholesterol and apolipoprotein B,but also can observe the increase of plaque stability through intracavitary imaging technology. At the same time,it can observe the decline of patients’ related inflammatory factor indicators,which may be related to the anti-inflammatory effect of statins in atherosclerosis

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