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NEJM：眼见为实！高强度他汀和依折麦布等逆转冠脉严重狭窄

2017-04-14 文韬 中国循环杂志

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近期《新英格兰医学杂志》刊登的一个病例表明，无论是冠脉CT，还是灌注成像，其清晰的图像均证明，药物治疗逆转斑块是有效的。

近期《新英格兰医学杂志》刊登的一个病例表明，无论是冠脉CT，还是灌注成像，其清晰的图像均证明，药物治疗逆转斑块是有效的。

患者为42岁男性，主因间歇性劳力性胸痛4个月就诊。

既往有高脂血症和冠状动脉疾病家族史。



运动心肌灌注成像显示左侧冠状动脉中度缺血（如图A箭头）。

冠状动脉CT显示，回旋支近段严重狭窄，有大量粥样硬化斑块（如图B箭头）。

之后患者服用高强度他汀、依折麦布、β受体阻滞剂和阿司匹林；并建议健康饮食和规律参加体育活动。之后症状缓解。

4年后，该患者报告又有胸痛不适，但不典型。再次心肌灌注显像未发现心肌缺血（图C箭头）。

冠脉CT示回旋支的斑块数量和狭窄严重程度明显减少（图D箭头）。证明患者症状与心脏无关。

这些影像学检查证实，即使严重冠脉狭窄，也是可以用药物逆转的。

原始出处：

Keraliya A, Blankstein R.   Regression of Coronary Atherosclerosis with Medical Therapy.   N Engl J Med. 2017 Apr 6;376(14):1370.

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    2017-04-24 虈亣靌

    学习过了，值得分享！！！

    0

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    2017-04-16 zhu_jun9841

    #依折麦布#

    0

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    2017-04-16 aids219

    #高强度#

    0

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    2017-04-14 虈亣靌

    不错的方式，努力学习，刻苦专研，不断总结出来新经验。

    0

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    2017-04-14 smartxiuxiu

    已成定论

    0

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