The Study Of Ultrasonic Characteristics Of Femoral Artery Plaques Of Patients With Coronary Heart Disease And The Effect Of Wendan Capsule Response To Plaques

ObjectivePurpose of this study is to investigate the neovascularization within plaque,volume,shape and internal echo of femoral artery atherosclerotic plaques of patients with non-ST-elevation acute coronary syndrome(NSTE-ACS)detected by contrast-enhanced ultrasonic imaging and 3-dimensional ultrasound combined with ultrasonic grey-scale intensity quantitative analysis,and explore the correlation between parameters of femoral artery atherosclerotic plaque and CHD,and evaluate the value of ultrasonic characteristics of femoral artery atherosclerotic plaques to identificate unstable plaque early and screen of high-risk patients with coronary heart disease.The second purpose of this study is to assess the effect of Wendan Capsule for the patients with NSTE-ACS to stabilize atherosclerotic plaques through the changes of above parameters.Methods1.92 cases of patients with femoral artery plaques were divided into two groups in according to the types of coronary heart disease:NSTE-ACS group(52 cases)and CIS group(40 cases).The internal echo grade,shape,volume,neovascularization grade,EI and EL of plaques were recorded by 3-dimensional ultrasound and contrast-enhanced ultrasonic imaging combined with ultrasonic grey-scale intensity quantitative analysis,and all parameters were analysised between the two groups to explore the correlation between ultrasonic characteristics of femoral artery atherosclerotic plaque and NSTE-ACS.2.45 cases of patients with NSTE-ACS were Randomized divided into three groups:group A received the treatment of the Wendan Capsule(15 cases),group B received the treatment of the atorvastatin(15 cases),group C treated by both the Wendan Capsule and atorvastatin(15 cases).To evaluate the effect of the Wendan Capsule by investigating the changes of TC,TG,HDL,LDL,neovascularization within plaque,volume,shape and internal echo of femoral artery atherosclerotic plaques of three groups before treatment and 3 months after the treatment.Results1.Compared basic information and the parameters of femoral artery plaque between two groups of patients:HDL of NSTE-ACS group(1.05±0.14 mmol/L)was lower than the CIS group(1.14±0.13 mmol/L),LDL of NSTE-ACS group(3.20±0.41 mmol/L)was higher than the CIS group(2.97±0.56 mmol/L),EL of femoral artery plaques of NSTE-ACS group(-42.75 dB)was lower than the CIS group(-37.15 dB),EI of femoral artery plaques of NSTE-ACS group(45.82±10.38 dB)was higher than the CIS group(37.23±11.40 dB),the difference was statistically significant(P<0.05).The proportion of low echo femoral artery plaques of NSTE-ACS group(61.54%)was higher than the CIS group(35.00%),the proportion of neovascularization III and IV grade femoral artery plaques of NSTE-ACS group(64.00%)was higher than the CIS group(40.00%),the proportion of irregular femoral artery plaques of NSTE-ACS group(63.46%)was higher than the CIS group(37.50%),the difference was statistically significant(P<0.05).The difference of age,sexual distinction,TC,TG and volume of plaques had no statistical significance(P>0.05).2.Correlation analysis between femoral artery plaque parameters of the two groups and NSTE-ACS:EL was negatively related to NSTE-ACS(r=-0.351).El was positively related to NSTE-ACS(r=0.'369).Internal echo grade was negatively related to NSTE-ACS(r=-0.263).Neovascularization grade was positively related to NSTE-ACS(r=0.237).Shape was positively related to NSTE-ACS C(r=0.258).The correlation coefficients were statistically significant(P<0.05).Logistic regression analysis showed that EL(OR=1.177,95%CI 0.823?1.682,P<0.05)andEI(OR=1.222,95%CI1.021?1.462,P<0.05)were risk factors for NSTE-ACS.ROC curve showed that EL and EI was effective in predicting NSTE-ACS,the AUC of EL and EI were 0.774 and 0.814 respectively.The diagnosis critical point was EL=-42.35 dB,and the corresponding sensitivity and specificity was 80.0%and 59.6%.The diagnosis critical point was EI=38.50 dB,and the corresponding sensitivity and specificity was 86.0%and 65.7%.When EL<-42.35 dB or EI>38.50 dB,EL and EI might be associated with NSTE-ACS.3.Compared blood lipids level and the parameters of femoral artery plaque of three groups of patients between before and after treatment:(1)Group A:after treatment,HDL increased from 1.07±0.11mmol/L to 1.08±0.10 mmol/L,LDL decreased from 3.22±0.36 mmol/L to 3.20±0.35 mmol/L,volume of plaques decreased from 0.24±0.08 cm3 to 0.23± 0.07 cm3,EL increased from-44.26±5.13 dB to-41.10±5.23 dB,EI decreased from 48.19±9.75 dB to 48.06±9.69 dB,and the difference was statistically significant(P<0.05);TC?TG had decrease,while the difference had no significance(P>0.05).(2)Group B:after treatment,TC decreased from 4.48±0.62 mmol/L to 4.45±0.61 mmol/L,TG decreased from 1.57±0.28 mmol/L to 1.53±0.25 mmol/L,HDL increased from 1.06±0.13 numol/L to 1.08±0.12 mmol/L,LDL decreased from 3.22±0.29 mmol/L to 3.19±0.25 mmol/L,volume of plaques decreased from 0.25±0.06 cm3 to 0.23±0.05 cm3,EL increased from-44.40±4.89 dB to-44.10±4.91 dB,EI decreased from 49.16±7.74 dB to 49.09±7.73 dB,and the difference was statistically significant(P<0.05).(3)Group C:after treatment,TC decreased from 4.48±0.62 mmol/L to 4.38±0.45 mmol/L,TG decreased from 1.55±0.29 mmol/L to 1.49±0.28 mmol/L,HDL increased from 1.05±0.15 mmol/L to 1.10±0.14 mmol/L,LDL decreased from 3.24±0.34 mmol/L to 3.17±0.33 mmol/L,volume of plaques decreased from 0.24±0.09 cm3 to 0.22±0.07 cm3,EL increased from-43.73±4.69 dB to-43.06±4.65 dB,EI decreased from 47.69±9.13 dB to 47.50±9.12 dB,and the difference was statistically significant(P<0.05).4.Compared the changes of blood lipids level and the parameters of femoral artery plaque between three groups of patients after treatment:The degree of decline of TC are not all the same,group C>group A,group C>group B,and the difference was statistically significant(P<0.05);the difference in the degree of decline of TC between group A and group B had no significance(P>0.05).The degree of decline of TG are not all the same,group C>group A,and the difference was statistically significant(P<0.05);the difference in the degree of decline of TC between group A and group B,group B and group C had no significance(P>0.05).The degree of increase of HDL are not all the same,group C>group A,group C>group B,and the difference was statistically significant(P<0.05);the difference in the degree of increase of HDL between group A and group B had no significance(P>0.05).The degree of decline of LDL are not all the same,group C>group A,group C>group B,and the difference was statistically significant(P<0.05);the difference in the degree of decline of LDL between group A and group B had no significance(P>0.05).The degree of increase of EL are not all the same,group C>group A,group C>group B,and the difference was statistically significant(P<0.05);the difference in the degree of increase of EL between group A and group B had no significance(P>0.05).The degree of decline of EI are not all the same,group C>group A,group C>group B,group A>group B,and the difference was statistically significant(P<0.05)?The difference in the degree of decline of volume between three groups had no significance(P>0.05).Conclusion1.The characteristics of femoral artery plaques of NSTE-ACS patients are low EL,irregular and rich neovascularization.Detecting ultrasonic characteristics of femoral artery atherosclerotic plaque is expected to provide reference index to identificate unstable plaque early and screen of high-risk patients with NSTE-ACS by using contrast-enhanced ultrasonic imaging and 3-dimensional ultrasound combined with ultrasonic grey-scale intensity quantitative analysis.2.Wendan Capsule can stabilize artery atherosclerotic plaques by regulating blood lipids,regulating internal composition of plaque,enhancing echo of plaque,reducing volume of plaque and inhibiting neovascularization hyperplasia of plaque.3.The effect of Wendan Capsule is more significant than atorvastatin in inhibiting neovascularization hyperplasia of plaque,and is similar to atorvastatin in regulating internal composition of plaque and enhancing echo of plaque.The effect of atorvastatin is more significant than Wendan Capsule in regulating blood lipids.The effect of Wendan Capsule combined with atorvastatin is more significant than single drug in regulating blood lipids,regulating internal composition of plaque,enhancing echo of plaque and inhibiting neovascularization hyperplasia of plaque.