The Efficacy Of Intensive Lipid-lowering Combined With Dual Antiplatelet Therapy In Acute Cerebral Infarction Patients As Well As Its Effects On Blood Lipid And Hypersensitive C-reactive Protein (CRP)

Background and Aim:Cerebrovascular disease caused by brain dysfunction resulting from cerebrovascular pathological changes, has become the third leading cause of death for the elderly. Because of the disease, family, society and country are subject to serious economic burden and mental damage. Cerebral infarction is the most common ischemic cerebrovascular disease, approximately 70% of all cerebrovascular accidents. It is commonly recognized that carotid artery atherosclerosis and stenosis, secondary platelet activation and thrombosis are the main pathological mechanisms of cerebral infarction. Therefore, lipid-lowering and antithrombotic therapy has gradually became the cornerstone therapy for ischemic cerebrovaslopathy. Additionally, inflammation has been found to play an important role in plaque stability, thus, suppression of inflammation has gradually been the focus.Atorvastatin gradually becomes the basis for the treatment of ischemic cerebrovascular disease for its potent anti-hyperlipidemia function and it is found to be involved in suppression of inflammation and stability of atherosclerotic plaque. Both clopidogrel and aspirin are anti-platelet drugs, combined utilization could strengthen their inhibition function of platelet aggregation. Hypersensitive c-reactive protein is an inflammatory marker of pathological process with atherosclerosis, whose expression could reflect the severity of atherosclerosis and cerebral infarction. Recent studies have confirmed the curative effect of applying dual antiplatelet or atorvastatin to prevent and treat various vascular diseases of heart head and brain. However, the curative effect of applying dual antiplatelet and atorvastatin treating Ischemic brain death, as well as the effect of dual antiplatelet and atorvastatin on hypersensitive c-reactive protein, are rarely reported. This study was conducted to investigate the effect of intensive lipid-lowering combined with dual antiplatelet therapy on blood lipid and hypersensitive C-reactive protein in acute cerebral infarction patients. Methods:120 patients with acute cerebral infarction were randomly divided into the atorvastain+dual anti-platelet group(group A,40 cases), the asprine group(group B,40 cases) and the clopidogrel goup(group C,40 cases). The NIHSS score, hs-CRP and serum lipids were observed before and 28 days after treatment.Results:1. After 4 weeks treatment, NIHSS score did not change too much, the different-ce was not statistically significant(P>0.05).2. The total concentration of serum cholesterol, triacylglycerol and low density lipoprotein were significantly lower than those of the control group(P<0.05),whereas the high density lipoprotein increased significantly than that before treatment and that of the control group(P>0.05).3. The level of hs-CRP decreased greatly after treatment, however, the amplitude in the observation group was larger(P<0.05).4. In our experiment, each safety index in all the three groups had no obvious change after treatment, and there was no significant adverse reaction in the process of treatment. Conclusions:The intensive lipid-lowering combined with dual antiplatelet therapy was safe and could synergistically rectify blood lipid disorders and reduce the hs-CRP level in acute cerebral infarction patients.