Clinical Study Of Probucal Combined With Atorvastatin In Patients With Severe Intracranial Artery Stenosis Or Occlusion

Objective: Evaluating the effect of probucal combined with atorvastatin treatment on the patients with severe intracranial artery stenosis or occlusion by magnetic resonance angiography(MRA).To observe the effect of combined therapy on lipid regulation,and the recurrence rate of ischemic cerebrovascular disease.And evaluating the safety of the two drugs.Methods: We collected a total of 71 patients from the neurology hospitalization and clinic of the second hospital of hebei medical university,from July 2014 to August 2015,into the investigation.All the patients were severe intracranial artery stenosis or occlusion diagnosed by head MRA.Patients in Group A were given atorvastatin 20 mg QN and conventional treatment of ischemic cerebrovascular disease,including 37 cases.Patients in Group B were given probucal 0.25 g BID,atorvastatin 20 mg QN and conventional treatment.The experiment was followed up for 6 months.The main indexes included blood lipid levels and Head MRA evaluation before and after the treatment.During the investigation,we also need monitor liver function,renal function,blood routine,muscle enzymes,blood sugar and observed any reactions including gastrointestinal symptoms,muscle pain,paresthesia,etc.Results:1 Lipid analysis:Comparison in group: After six months' treatment,the TC,TG and LDL levels of Group A and Group B were reduced obviously(P<0.05).The level of HDL in Group A had no obvious change(P>0.05),but the level of HDL Group B reduced,and the difference was statistically significant(P<0.05).Comparison among two groups: Comparing among two groups of patients before treatment,there was no significant difference in TC,TG,LDL and HDL levels(P>0.05).After six months' treatment,there was significant difference in TC,TG,LDL and HDL levels among two groups,Group B could significantly reduce the TC,TG,LDL and HDL levels,compared with Group A,the difference was statistically significant(P<0.05).2 Comparison of Head MRA results among two groups:After six months' treatment,it showed that there was statistically significant difference in two groups.The improvement rate of IAS in two groups were 27%and 51.5%.It showed that Group B could significantly raise the improvement rate of IAS,compared with Group A,the difference was statistically significant(P<0.05).3 Comparison of recurrence rate of ICVD:By telephone followed-up,there was no recurrence in the two groups after three months' treatment.After six months' treatment,the incidence of ICVD events was 16.2%(6 case)and 0(0 case)in Group A and Group B.The results showed that Group B can reduce recurrence rate of ICVD,compared with Group A,and the difference was statistically significant(P<0.05).4 Safety evaluation of probucol and atorvastatin:The incidence of adverse events were 8.8% and 11.8% in Group A and Group B.One case withdrew from the study because of the ECG indicated long QT interval.In each group,there were 3 patients whose ALT increased,but less than ALT three time higher.The side effect differences were no statistically significant between two groups(P>0.05).Conclusions: Probucol combined with atorvastatin does well in the patients of ischemic cerebrovascular disease with IAS.Combined treatment can make blood lipid level lower than atorvastatin treatment single,and combined can reduce the recurrence rate of ischemic cerebrovascular disease events obviously,but adverse reaction rate of combined in is not significantly increased,compared with atorvastatin single.We can conclude that combined can prevent the progression of intracranial atherosclerosis better than atorvastatin treatment only by head MRA.