心血管

订阅

MedSci主页 / 所有栏目 / 心血管

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

关注

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.

版权声明：
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料，版权均属于梅斯医学所有。非经授权，任何媒体、网站或个人不得转载，授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章，或“梅斯号”自媒体发布的文章，仅系出于传递更多信息之目的，本站仅负责审核内容合规，其内容不代表本站立场，本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系，我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=190149, encodeId=2000190149ba, content=学习过了，值得分享！！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Apr 24 13:44:42 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1531031, encodeId=5e47153103161, content=<a href='/topic/show?id=f70f26896f8' target=_blank style='color:#2F92EE;'>#依折麦布#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26896, encryptionId=f70f26896f8, topicName=依折麦布)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f68912191404, createdName=zhu_jun9841, createdTime=Sun Apr 16 01:28:00 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603996, encodeId=17ce16039963e, content=<a href='/topic/show?id=67b81023e6ea' target=_blank style='color:#2F92EE;'>#高强度#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102376, encryptionId=67b81023e6ea, topicName=高强度)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=79d219134728, createdName=aids219, createdTime=Sun Apr 16 01:28:00 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187456, encodeId=e67c18e4569a, content=不错的方式，努力学习，刻苦专研，不断总结出来新经验。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Fri Apr 14 21:46:59 CST 2017, time=2017-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187410, encodeId=194f18e4101b, content=已成定论, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Fri Apr 14 15:41:41 CST 2017, time=2017-04-14, status=1, ipAttribution=)]
    2017-04-24 虈亣靌

    学习过了，值得分享！！！

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=190149, encodeId=2000190149ba, content=学习过了，值得分享！！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Apr 24 13:44:42 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1531031, encodeId=5e47153103161, content=<a href='/topic/show?id=f70f26896f8' target=_blank style='color:#2F92EE;'>#依折麦布#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26896, encryptionId=f70f26896f8, topicName=依折麦布)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f68912191404, createdName=zhu_jun9841, createdTime=Sun Apr 16 01:28:00 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603996, encodeId=17ce16039963e, content=<a href='/topic/show?id=67b81023e6ea' target=_blank style='color:#2F92EE;'>#高强度#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102376, encryptionId=67b81023e6ea, topicName=高强度)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=79d219134728, createdName=aids219, createdTime=Sun Apr 16 01:28:00 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187456, encodeId=e67c18e4569a, content=不错的方式，努力学习，刻苦专研，不断总结出来新经验。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Fri Apr 14 21:46:59 CST 2017, time=2017-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187410, encodeId=194f18e4101b, content=已成定论, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Fri Apr 14 15:41:41 CST 2017, time=2017-04-14, status=1, ipAttribution=)]
    2017-04-16 zhu_jun9841

    #依折麦布#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=190149, encodeId=2000190149ba, content=学习过了，值得分享！！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Apr 24 13:44:42 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1531031, encodeId=5e47153103161, content=<a href='/topic/show?id=f70f26896f8' target=_blank style='color:#2F92EE;'>#依折麦布#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26896, encryptionId=f70f26896f8, topicName=依折麦布)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f68912191404, createdName=zhu_jun9841, createdTime=Sun Apr 16 01:28:00 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603996, encodeId=17ce16039963e, content=<a href='/topic/show?id=67b81023e6ea' target=_blank style='color:#2F92EE;'>#高强度#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102376, encryptionId=67b81023e6ea, topicName=高强度)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=79d219134728, createdName=aids219, createdTime=Sun Apr 16 01:28:00 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187456, encodeId=e67c18e4569a, content=不错的方式，努力学习，刻苦专研，不断总结出来新经验。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Fri Apr 14 21:46:59 CST 2017, time=2017-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187410, encodeId=194f18e4101b, content=已成定论, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Fri Apr 14 15:41:41 CST 2017, time=2017-04-14, status=1, ipAttribution=)]
    2017-04-16 aids219

    #高强度#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=190149, encodeId=2000190149ba, content=学习过了，值得分享！！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Apr 24 13:44:42 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1531031, encodeId=5e47153103161, content=<a href='/topic/show?id=f70f26896f8' target=_blank style='color:#2F92EE;'>#依折麦布#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26896, encryptionId=f70f26896f8, topicName=依折麦布)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f68912191404, createdName=zhu_jun9841, createdTime=Sun Apr 16 01:28:00 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603996, encodeId=17ce16039963e, content=<a href='/topic/show?id=67b81023e6ea' target=_blank style='color:#2F92EE;'>#高强度#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102376, encryptionId=67b81023e6ea, topicName=高强度)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=79d219134728, createdName=aids219, createdTime=Sun Apr 16 01:28:00 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187456, encodeId=e67c18e4569a, content=不错的方式，努力学习，刻苦专研，不断总结出来新经验。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Fri Apr 14 21:46:59 CST 2017, time=2017-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187410, encodeId=194f18e4101b, content=已成定论, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Fri Apr 14 15:41:41 CST 2017, time=2017-04-14, status=1, ipAttribution=)]
    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

  5. [GetPortalCommentsPageByObjectIdResponse(id=190149, encodeId=2000190149ba, content=学习过了，值得分享！！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Apr 24 13:44:42 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1531031, encodeId=5e47153103161, content=<a href='/topic/show?id=f70f26896f8' target=_blank style='color:#2F92EE;'>#依折麦布#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26896, encryptionId=f70f26896f8, topicName=依折麦布)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f68912191404, createdName=zhu_jun9841, createdTime=Sun Apr 16 01:28:00 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603996, encodeId=17ce16039963e, content=<a href='/topic/show?id=67b81023e6ea' target=_blank style='color:#2F92EE;'>#高强度#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102376, encryptionId=67b81023e6ea, topicName=高强度)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=79d219134728, createdName=aids219, createdTime=Sun Apr 16 01:28:00 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187456, encodeId=e67c18e4569a, content=不错的方式，努力学习，刻苦专研，不断总结出来新经验。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Fri Apr 14 21:46:59 CST 2017, time=2017-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187410, encodeId=194f18e4101b, content=已成定论, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Fri Apr 14 15:41:41 CST 2017, time=2017-04-14, status=1, ipAttribution=)]
    2017-04-14 smartxiuxiu

    已成定论

    0