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目的研究老年性主动脉瓣狭窄应用他汀类药物对狭窄进程的影响。方法将123例无症状中至重度主动脉瓣狭窄(AS)(主动脉瓣口面积≥1.0 cm2)患者,随机分为治疗组(61例)和对照组(62例),对照组通过改善生活方式、运动及伴发因素处理,治疗组在上述基础上加用阿托伐他汀(立普安)10 mg/d,观察72~96周,平均85周,应用彩色多普勒超声测定治疗前及治疗结束时主动脉瓣口面积及血流速度。结果治疗组主动脉瓣的瓣口面积缩窄程度明显减慢,为0.05 cm2/年,主动脉瓣口最大血流速度每年增幅减慢为0.04 m/s;对照组瓣口面积缩窄程度为0.1 cm2/年,瓣口最大血流速度每年增幅减慢为0.24 m/s,两组差异有统计学意义(P<0.05),低密度脂蛋白(LDL-C)治疗组亦有显著改善,治疗期间无严重不良反应发生。结论他汀类治疗不但显著降低血脂和炎症标志物水平,还可以改善超声心动图的血流动力学指标,延缓主动脉瓣的退行性病变进程。
Objective To study the effects of statins on the progression of stenosis in senile aortic stenosis. Methods A total of 123 asymptomatic patients with moderate to severe aortic stenosis (AS) (aortic valve area≥1.0 cm2) were randomly divided into treatment group (61 cases) and control group (62 cases). The control group The patients in the treatment group were given atorvastatin (LIPA) 10 mg / d on the basis of the above, and were observed for 72-96 weeks with an average of 85 weeks. Color Doppler echocardiography was performed before treatment And the aortic valve area and blood flow velocity at the end of treatment. Results In the treatment group, the aortic valve area constriction was significantly slowed down to 0.05 cm2 / year, and the maximum aortic valve velocity slowed down to 0.04 m / s per year. In the control group, the area of the valve orifice constriction was (P <0.05). LDL-C treatment group also had a significant improvement, with the increase of 0.1 cm / No serious adverse reactions occurred during treatment. Conclusion Statin treatment not only significantly reduced the levels of lipid and inflammatory markers, but also improved the hemodynamic parameters of echocardiography and delayed the process of degenerative aortic valve disease.