过去20年间,EULAR制定了广为应用的EULAR干燥综合征疾病活动指数(European league against rheumatism Sjögren's syndrome patient reported index,ESSDAI)和EULAR干燥综合征患者报告指数(European league against rheumatism...过去20年间,EULAR制定了广为应用的EULAR干燥综合征疾病活动指数(European league against rheumatism Sjögren's syndrome patient reported index,ESSDAI)和EULAR干燥综合征患者报告指数(European league against rheumatism Sjögren's syndrome patient reported index,ESSPRI),分别作为衡量系统活动和患者症状的参考指标。ESSDAI在监测疾病活动变化和评估治疗效果中表现良好,但也存在局限性。作为RCT中的主要终点,ESSDAI未能涵纳pSS所有重要的疾病特征,如患者症状和腺体功能,因此,目前应该建立一个可以更全面评估疾病的工具。展开更多
Objectives: We sought to elucidate the effects of 20- mg versus 5- mg atorvastatin on thoracic and abdominal aortic plaques. Background: Regression of thoracic aortic plaques by simvastatin was demonstrated using magn...Objectives: We sought to elucidate the effects of 20- mg versus 5- mg atorvastatin on thoracic and abdominal aortic plaques. Background: Regression of thoracic aortic plaques by simvastatin was demonstrated using magnetic resonance imaging(MRI). However, the effects of different doses of statin have not been assessed. Methods: Using MRI, we investigated the effects of 20- mg versus 5- mg atorvastatin on thoracic and abdominal aortic plaques in 40 hypercholesterolemic patients who were randomized to receive either dose. Treatment effects were evaluated as changes in vessel wall thickness(VWT) and vessel wall area(VWA) of atherosclerotic lesions from baseline to 12 months of treatment. Results: The 20- mg dose induced a greater low- density lipoprotein(LDL) cholesterol reduction than did the 5- mg dose(- 47% vs.- 34% , p< 0.001). Although 20 mg and 5 mg reduced C- reactive protein(CRP) levels(- 47% and- 28% ), the degree of CRP reduction did not differ between the two doses. The 20- mg dose reduced VWT and VWA of thoracic aortic plaques(- 12% and - 18% , p< 0.001), whereas 5 mg did not(+ 1% and + 4% ). Regarding abdominal aortic plaques, even 20 mg could not reduce VWT or VWA(- 1% and + 3% ), but instead progression was observed with 5mg treatment(+ 5% and + 12% , p< 0.01). Notably, the degree of plaque regression in thoracic aorta correlated with LDL cholesterol(r=0.64) and CRP(r=0.49) reductions. Although changes in abdominal aortic plaques only weakly correlated with LDL cholesterol reduction(r=0.34), they correlated with age(r=0.41). Conclusions: One- year 20- mg atorvastatin treatment induced regression of thoracic aortic plaques with marked LDL cholesterol reduction, whereas it resulted in only retardation of plaque progression in abdominal aorta. Thoracic and abdominal aortic plaques may have different susceptibilities to lipid lowering.展开更多
文摘过去20年间,EULAR制定了广为应用的EULAR干燥综合征疾病活动指数(European league against rheumatism Sjögren's syndrome patient reported index,ESSDAI)和EULAR干燥综合征患者报告指数(European league against rheumatism Sjögren's syndrome patient reported index,ESSPRI),分别作为衡量系统活动和患者症状的参考指标。ESSDAI在监测疾病活动变化和评估治疗效果中表现良好,但也存在局限性。作为RCT中的主要终点,ESSDAI未能涵纳pSS所有重要的疾病特征,如患者症状和腺体功能,因此,目前应该建立一个可以更全面评估疾病的工具。
文摘Objectives: We sought to elucidate the effects of 20- mg versus 5- mg atorvastatin on thoracic and abdominal aortic plaques. Background: Regression of thoracic aortic plaques by simvastatin was demonstrated using magnetic resonance imaging(MRI). However, the effects of different doses of statin have not been assessed. Methods: Using MRI, we investigated the effects of 20- mg versus 5- mg atorvastatin on thoracic and abdominal aortic plaques in 40 hypercholesterolemic patients who were randomized to receive either dose. Treatment effects were evaluated as changes in vessel wall thickness(VWT) and vessel wall area(VWA) of atherosclerotic lesions from baseline to 12 months of treatment. Results: The 20- mg dose induced a greater low- density lipoprotein(LDL) cholesterol reduction than did the 5- mg dose(- 47% vs.- 34% , p< 0.001). Although 20 mg and 5 mg reduced C- reactive protein(CRP) levels(- 47% and- 28% ), the degree of CRP reduction did not differ between the two doses. The 20- mg dose reduced VWT and VWA of thoracic aortic plaques(- 12% and - 18% , p< 0.001), whereas 5 mg did not(+ 1% and + 4% ). Regarding abdominal aortic plaques, even 20 mg could not reduce VWT or VWA(- 1% and + 3% ), but instead progression was observed with 5mg treatment(+ 5% and + 12% , p< 0.01). Notably, the degree of plaque regression in thoracic aorta correlated with LDL cholesterol(r=0.64) and CRP(r=0.49) reductions. Although changes in abdominal aortic plaques only weakly correlated with LDL cholesterol reduction(r=0.34), they correlated with age(r=0.41). Conclusions: One- year 20- mg atorvastatin treatment induced regression of thoracic aortic plaques with marked LDL cholesterol reduction, whereas it resulted in only retardation of plaque progression in abdominal aorta. Thoracic and abdominal aortic plaques may have different susceptibilities to lipid lowering.
