The Comparative Study Of Efficacy On Vulnerable Plaque Reversion Between PAS Method And AS Method

Objective: Cerebrovascular disease is a severe disease which threatens people's health,and atherosclerasis is its major reason.A large number of evidences has proved that intervening atherosclerosis positively can deduce morbidity and mortality of cardiovascular and cerebrovascular diseases.It is necessary to search a more safe and efficient method.To explore if there were some differences between PAS method and AS method on the effect of vulnerable plaque reversion in patients with vulnerable plaque in order to search for a efficient method to deduce the risk of cerebrovascular disease.Methods:120 cases of patients with vulnerable plaques detected by carotid vascular ultrasound were enrolled in Tangshan workers hospital from from June 2015 to September 2015.According to the paired method,120 patients were randomizated into group PAS(n=60)and group AS(n=60).The patients in PAS group were treated with probucol 0.5g 2 times a day,atorvastatin 20 mg once a day and aspirin 100 mg once a day before asleep.While patients in AS group were treated with atorvastatin 20 mg once a day and aspirin 100 mg once a day before asleep.Both groups took blood samples for test and carotid vescular ultrasonography before and after six-month treatment.Patients were followed for six months.The effect of two therapies were evaluated based on the data obtained from the study.All data were analyzed by SPSS17.0 statistical software.Firstly,the data were analysed using normality test.Results which conform to the law of normal distribution were expressed as mean value±SD,and the t-test was used to compare mean value of two groups.Data that not conform to the law of normal distribution were expressed as median ± quartile range,and nonparametric test of rank transformation was used to compare mean value of two groups.All enumeration data were expressed as a percentage.Differences in frequencies were compared using the chi-square test,as appropriate.A p value <0.05 was considered statistically difference in all analyses,and when p value<0.01 was believed to be Significant deviation.Results: 1.In this study,120 cases were enrolled,8 cases of which lost to follow-up,and 23 cases were poor on compliance that stop taking drugs by themselves,thus quitting this study.One case of AS group died(considering succumb to cerebral hernia resulted from large area cerebral infarction rather than intake drugs).There were remained 44 cases in PAS group,33 male and 11 female,with average age was 64.53±7.69 years old.45 cases remained in AS group,31 male and 14 female,and the average age was 64.47±7.20 years old.According to t-test and chi-square,there were no statistical differences between the clinical data base of two groups(P>0.05).The two groups were comparable.2.The level of TC in PAS group before and after treatment were 5.08±1.45mmol/L and 3.66±1.41 mmol/L respectively,TG level were 1.89±1.08 mmol/L and 1.26±1.04 mmol/L respectively,LDL level were 2.66±1.01 mmol/L and 1.95±0.99 mmol/L respectively,HDL level were 1.06±0.79 mmol/L and 0.66±0.78 mmol/L respectively.The level of TC in AS group before and after treatment were 4.71±1.16 mmol/L and 3.69±1.27 mmol/L respectively,TG level were 1.68±0.83 mmol/L and 1.13±0.86 mmol/L respectively,LDL level were 2.60±0.84 mmol/L and 2.14±0.86 mmol/L respectively,HDL level were 0.90±0.15 mmol/L and 1.07±0.20 mmol/L respectively.Level of TC?TG?LDL of both group were significant declined after 6-month treatment(P<0.01),however,level of HDL in PAS group was significant increased(P<0.01)while level of HDL in AS group was significant decreased(P<0.01).3.The level of hs-CRP in PAS group before and after treatment were 2.87±2.79 mg/L and 2.14±2.72 mg/L respectively,level of sCD40 L were 656.27±130.26 pg/ml and 351.64±137.14 pg/ml respectively,level of MMPs-9 were 14.81±3.88?g/L and 7.63±3.99?g/L respectively.The level of hs-CRP in AS group before and after treatment were 4.70±6.55mg/L and 4.11±6.53 mg/L respectively,level of sCD40 L were 653.24±107.34 pg/ml and 435.21±130.16 pg/ml respectively,level of MMPs-9 were 15.84±2.56?g/L and 12.07±2.89?g/L respectively.Level of hs-CRP,sCD40 L and MMPs-9 of both group were significant declined after 6-month treatment(P<0.01).4.The D-value of TC,LDL,HDL,hs-CRP,sCD40 L and MMPs-9 before and after treatment of PAS group were significant higher than those in AS group(P<0.01).On the contrary,there was no statistical difference on TG level between two groups(P>0.05).5.Statistical differences of distribution of different types plaque was observed(P<0.01)in PAS group,but there is no statistical differences in AS group.PAS group surpassed AS group significantly on the effect of reduce Crouse integrals and development of type of vulnerable plaque(P<0.01).6.Adverse reaction:there was one case in PAS group appeared fallacia optica,considering caplendused Mori Fukura,and the symptom disappeared after replaced by trastal.2 cases of PAS group and 1 case of AS group had a slightly increase of aminopherase,and decreased to the normal level after adding liver protectant.Conclusions:1 Both PAS method and AS method could reduce the density of blood fat and serum inflammatory factors,but PAS method is outstripped over AS method.2 PAS method and AS method can significantly reduce Crouse integrals and intensify the echogenicity of vulnerable plaque.PAS method surpasses AS method.3 PAS method can reverse vulnerable plaque more safely through antiplatelet aggregative activity,anti-inflammatory and antioxidation.