| ObjectiveFor patients with ultra-high risk atherosclerotic cardiovascular disease(ASCVD)complicated with carotid plaque,Carotid ultrasound was used to evaluate the clinical efficacy of atorvastatin combined with ezetimibe in the treatment of atherosclerosis.Methods:105 cases of ultra-high risk atherosclerotic cardiovascular disease(ASCVD)treated in Jingzhou First People’s Hospital from October 2019 to December 2020 were selected as the research subjects.They were randomly divided into experimental group(Atorvastatin 20mg/d combined with Ezetimibe 10mg/d)and control group(Atorvastatin20mg/d),with 53 cases in experimental group and 52 cases in control group.There was no significant difference in sex ratio and mean age(P<0.05).All patients were treated for 6 months.Patients in both groups were given antihypertensive drugs,nitrates,aspirin and other conventional treatments according to their conditions,and patients with concurrent diseases were treated with corresponding measures.Experimental group was treated with Atorvastatin combined with Ezetimibe.Atorvastatin 20 mg orally at bedtime,once a day;Ezetimibe 10 mg orally,once a day.The control group was given only Atorvastatin tablets orally,and the usage and dosage were the same as that of the combined group.Before and after treatment,lipid indicators including triglyceride(TG),total cholesterol(TC),high density lipoprotein(HDL-C)and low density lipoprotein(LDL-C)were measured,respectively.Carotid intra-arterial media thickness(IMT)and total plaque score were measured by ultrasonography before and after treatment,respectively,to evaluate the treatment effect of the two groups.Liver function indexes,including aspartate aminotransferase(AST)and alanine aminotransferase(ALT),high sensitivity C-reactive protein,kidney function indexes,including creatinine(Cr),and various kinase indexes,including creatine kinase isoenzyme(CK-MB)and creatine kinase(CK),were also monitored.Adverse drug reactions during medication treatment were recorded.SPSS 24.0 statistical software was used to analyze the data,and P< 0.05 was considered statistically significant.Results:1.After 6 months of clinical treatment with the two lipid-lowering regimens,27 patients in the experimental group reached the LDL-C standard,the compliance rate was50.94%.There were 13 LDL-C patients in the control group,the compliance rate was25.00% and the difference was statistically significant.The effective rate in the experimental group was significantly higher than that in the control group(P<0.05).The experimental group included 32 patients with non-HDL-C standard,the compliance rate was 60.38%.There were 37 non-HDL-C patients in the control group,the compliance rate was 71.15% and the difference was not statistically significant,which could not indicate that the effective rate of the experimental group was higher than the control group(P>0.05).2.The triglycerides of the experimental group were 3.37±1.37mmol/L before treatment and 1.94±0.87mmol/L after treatment,and the difference was statistically significant(P<0.05).The total blood cholesterol in the experimental group was5.84±0.84mmol/L before treatment and 4.26±1.12mmol/L after treatment,with statistical difference(P<0.05).Blood high-density lipoprotein of the experimental group was0.83±0.19mmol/L before treatment and 1.44±0.14 mmol /L after treatment,with statistical difference(P<0.05).The serum LDL of the experimental group was 4.09±1.71mmol/L before treatment and 1.75±0.99mmol/L after treatment,and the difference was statistically significant(P<0.05).The triglycerides in the control group were3.40±1.23mmol/L before treatment and 2.19±0.97mmol/L after treatment,with statistical difference(P<0.05).The total blood cholesterol of control group was 5.86±0.68mmol/L before treatment and 4.33±1.29mmol/L after treatment,with statistical difference(P <0.05).The blood high-density lipoprotein of the control group was 0.78±0.22 mmol /L before treatment and 1.07±0.21 mmol /L after treatment,with statistical difference(P<0.05).Low density lipoprotein(LDL)in the control group was 3.56±1.43mmol/L before treatment and 2.18±1.16mmol/L after treatment,with statistical difference(P<0.05).3.The thickness of media-carotid artery in the experimental group was 1.37±0.19 mm before treatment and 1.12±0.16 mm after treatment,the difference was statistically significant(P<0.05).In the control group,the thickness of media-carotid artery was 1.34±0.24 mm before treatment and 1.23±0.12 mm after treatment,and the difference was statistically significant(P<0.05).The total score of carotid plaque in the experimental group was 6.94±1.01 before treatment and 4.20±0.83 after treatment,and the difference was statistically significant(P<0.05).The total score of carotid plaque in the control group was 7.06±1.11 before treatment and 5.21±0.73 after treatment,the difference was statistically significant(P<0.05).Conclusion:Ultrasonography confirmed that the combined treatment of atorvastatin and ezetimibe can effectively reduce blood lipid,anti-atherosclerosis and reverse plaques,which is more effective than atorvastatin alone.Therefore,it is worthy of wide application in clinical practice. |
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