The Therapy Effect Of Atherosclerosis With Statin Monotherapyversus Statin And Probucol Combination

Background:Carotid atherosclerosis and coronary atherosclerosis, which are parts ofthe systemic atherosclerosis, have the similar pathologicalbasis. The injury of the endothelial cell, lipid infiltration, thrombosisformation and oxidative stress involve in the process.Many domen-Ic and abroad experimental study display that, the combination ofanti-platelet aggregation, lipid-lowering and antioxidant can block thedevelopment of atherosclerosis and play the role of reversal ofatherosclerosis plaque. The research named CHALLENGER whichissued by ACC in2004shows that rosuvastain can reduce the area of theplaque in carotid atherosclerosis patients, thus can treat the carotidatherosclerosis.This experiment use aspirin, rosuvastatin/atorvastatinand probucoltogether to block the origin and develop-ment of atherosclerosis bythe effect of anti-platelet aggregation,lipid-lowering and antioxidant.Through comparison of the area of thecarotid artery plaque and the percent of vascular stenosis be-fore andafter treatment to investigate the effect of statin monothe-rapy versusstatin and probucol combinationin the therapy of athe-rosclerosis. Experimental Purpose:1.The main purpose:Investigate the effect of PAS therapy (combinationof probucol、 aspirin、 atorvastatin/rosuvastatin) and AS therapy(combination of aspirin、atorvastatin/rosuvastatin) on patie-nts withcarotid atherosclerosis and coronary atherosclerosis.2.The second purpose:Investigate the effect of PAS therapy and AStherapy on the high density lipoprotein cholesterol and thestandard-reaching rate of the low density lipoprotein cholesterol onemonth later.Experimental Methods:1.Select seventy patients who visited OPD and IPD ofCardiologyDepartment, Second Hospital of Jilin University between May2013and May2014.Mean age was61±7.65years, with forty-five fema-les and twenty-five males. Inclusion criteria were, the patients withcarotid artery plaque diagnosed by the Color Doppler ultrasoundexamination. Randomly divided these patients into two groups: the firstgroup named AS(aspirin、rosuvastatin), which was aspirin100mg/d，rosuvastatin10mg/d；the second group names PAS(probucol、aspirin androsuvastatin) which was aspirin100mg/d，rosuvastatin10mg/d, probucol0.5g/d。Before and after half a year, detected and compared the area ofcarotid artery plaque. All data were analyzed using SPSS19.0software. Ap value <0.05was considered statistically significant, p value>0.05wasconsidered statistically insignificant. 2.Select one hundred and twenty patients who visited OPD and IPD ofCardiology Department, Second Hospital of Jilin University betweenMay2013and May2014.Mean age was65±8.47years, with forty femalesand eighty males. Inclusion criteria were, the pat-ients with at least avessel coronary artery stenosis greater than or equal to twenty percentdiagnosed by256-slice spiral CT examinat-ion.Randomly divided thesepatients into two groups: the first gro-up named AS(aspirin、atorvastatin),which was aspirin100mg/d，atorvastatin20mg/d；the second group namesPAS（probucol、aspirin and atorvastatin)which was aspirin100mg/d，atorvastatin20mg/d,probucol0.5g/d.Before and after a month,detectedand compared the level of the high density lipoprotein cholesterol and thestandard-reaching rate of the low density lipoprotein cholester-ol.Beforeand after a year, detected and compared the percent of vascular stenosis.All data were analyzed using SPSS19.0softwar-e.A p value <0.05wasconsidered statistically significant, p value>0.05was consideredstatistically insignificant.Results:1.The area of carotid artery plaque: In PAS treatment group, the averagearea of carotid artery plaque: before treatment was0.197±0.12, aftertreatment was0.129±0.67,the area of carotid artery plaque before andafter treatment has statistical significance（p=0.015＜0.05).In AS controlgroup, the average area of carotid artery plaque: before treatment was 0.259±0.16,after treatment was0.229±0.15, the area of carotid arteryplaque before and after treatment has statistical significance（p=0.024＜0.05).But in PAS treatment group the area of carotid artery plaque is moreobvious than AS control group（p＜0.05）.2.1.The Percent of Vascular Stenosis: In PAS treatment group, the percent of vascular stenosis before treatment was(0.399±0.24), after treatment was(0.281±0.26),the percent of vascular stenosis before andafter treatment has statistical significance（p=0.00＜0.01).In AS control group, the percent of vascular stenosis before treatment was(0.358±0.19)after treatment was(0.289±0.21). the percent of vascular stenosis before and after treatment has statistical significance（p=0.02＜0.05).But in PAS treatment group the reversal of coronary atherosclerotic plaques is more obvious than AS control group（p＜0.05）.2.2.In PAS treatment group,the level of the high density lipoproteincholesterol before treatment was (1.17±0.36),after treatment was (1.02±0.46),the level of the high density lipoprotein cholesterol before and after treatment has statistical significance（p=0.018＜0.05).In AS treatment group,the level of the high density lipoprotein cholesterolbefore treatment was (1.13±0.34),after treatment was(1.03±0.24),the level of the high density lipoprotein cholesterol before and after treatment has no statistical significance（p=0.063>0.05).2.3.In PAS treatment group, the standard-reaching rate of the low den sity lipoprotein cholesterol was sixty nine point five percent,in AS treatment group,it was fivety four point two percent.Conclusions:1.Statins,no matter atorvastatin or rosuvastatin combination with probucol can reverse the atherosclerotic plaque.PAS is more effectivelythan AS in the reversal of the atherosclerotic plaque.2.Statins combination with probucol significantly decreased the levelof high density lipoprotein cholesterol and raised the standard-reaching rate of the low density lipoprotein cholesterol.