Effects of valsartan on the carotid artery atherosclerotic plaques and the serum hs-CRP in patients with coronary artery disease
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摘要: 目的:探讨缬沙坦坦对冠心病患者颈动脉内膜中层厚度 (IMT) 及颈动脉斑块的影响。方法:177例冠心病患者随机分为两组, 治疗组服用缬沙坦80160mg/d, 对照组给予安慰剂。对照组中合并高血压者给予其他降压药 (除外血管紧张素Ⅱ受体拮抗剂和血管紧张素转化酶抑制剂)。两组患者血压均控制在140/90mmHg (1mmHg=0.133kPa) 以下。治疗前后以彩色多普勒超声检测所有患者IMT及颈动脉斑块, 并测定血清高敏C反应蛋白 (hs-CRP) 水平, 同时观察冠心病事件发生率和冠状动脉 (冠脉) 血运重建率。结果:24个月后, 治疗组颈动脉IMT值、血清hs-CRP以及颈动脉斑块大小、数量和厚度均较治疗前明显下降 (均P<0.01)。对照组颈动脉IMT值、血清hs-CRP以及颈动脉斑块大小、数量和厚度呈下降趋势, 但差异无统计学意义。随访期间, 治疗组冠心病事件发生率和冠脉血运重建率明显低于对照组。结论:血管紧张素Ⅱ受体拮抗剂缬沙坦能逆转动脉粥样硬化, 抑制斑块内炎症反应, 消退动脉斑块, 降低冠心病事件发生率和冠脉血运重建率。Abstract: Objective: To evaluate the clinical antiatheroscleosis effects of valsartan on atherosclerotic carotid artery in patients with coronary artery disease.Method: All 177patients with coronary artery disease were randomed to therapy group and control group.The patients in therapy group were recieved with valsartan 80160mg/d. The placebos were given to the control group.Patients with hypertension in cantrol group were treated with other antihypertensive drugs except angiotensin-converting enzyme inhibitor and angiotensinⅡ receptor blocker.Blood presure of patients in two groups were controlled under 140/90mmHg (1mmHg=0.133kPa).The carotid intima-media thickness (IMT) and atherosclerotic plaques were measured with color Doppler ultrasonograms before and after 24 months treatment.The serum hs-CRP was also determined.The ratio of coronary heart disease events and coronary revascularization were observed.Result: The IMT and the size, quantity and thickness of carotid atherosclerotic plaques, the serum hs-CRP in therapy group were decreased more significantly than those in control group.During follow-up period, the ratio of coronary heart disease events and coronary revascularization in therapy group was significantly lower than those in control group.Conclusion: Valsartan can decrease IMT and the ratio of coronary heart disease events and coronary revascularization, and inhibit the inflammatory reaction of atherosclerotic plaques and reverse carotid atherosclerotic plaques after long time treatment.
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Key words:
- coronary artery disease /
- atheroscleosis /
- valsartan /
- intima-media thickness
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