PAS疗法对颈动脉粥样硬化的疗效观察

目的观察联合应用阿司匹林、阿托伐他汀、普罗布考(PAS疗法)对于颈动脉粥样硬化的疗效。方法观察80例缺血性脑血管病合并颈动脉粥样硬化患者,将其分为PAS治疗组和AS对照组进行比较研究。PAS治疗组40例,应用普罗布考(0.5g/d),阿司匹林(100mg/d),阿托伐他汀钙(20mg/d);AS对照组40例,予阿司匹林(100mg/d),阿托伐他汀钙(20mg/d)。共随访3个月,分别在治疗前、治疗后3个月检测血脂(TC、TG、LDL-C、HDL-C)及血清高敏C反应蛋白(hs-CRP),比较颈动脉内-中膜厚度(IMT)及颈动脉斑块积分的变化。结果治疗后PAS治疗组及AS对照组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及hs-CRP含量均下降(P0.05),PAS治疗组更明显(P0.01);PAS治疗组的颈动脉斑块积分有轻微下降趋势(P0.05)。结论(1)阿司匹林、阿托伐他汀、普罗布考联合治疗动脉粥样硬化调脂、降低炎症指标hs-CRP效果明显优于阿司匹林、阿托伐他汀联用效果明显。(2)稳定颈动脉粥样斑块需长期进一步观察才能得出结论。

Efficacy Observatiom on PAS Therapy for Carotid Atherosclerosis

Objective To investigate the effects of combination therapy of probucol, atorvastatin calcium and aspirin drugs （PAS） on patients with carotid atherosclerosis. Method A total of 80 patients with ischemic cerebrvascular disease complicated with carotid arteriosclerosis were randomized into two groups. 40 cases in PAS treatment group were treated with probucol （0. 5g/d）, atorvastatin calcium （20mg/d） and aspirin （100mg/d）. 40 cases in AS control group were treated with atorvastatin calcium （20mg/d） and aspirin （ 100mg/d ）. The serum lipids （ TC, TG, LDL-C, HDL-C ）, high-sensitivity C-reactive protein （ hs-CRP）, intimamedia thickness（IMT） of carotid arterial and carotid plaques score were measured before and three months after treatment. Results Serum total cholesterol （ TC ）, low density lipoprotein-eholesterol （ LDL-C ）, hs-CRP levels in both PAS treatment group and AS control group reduced after the treatment （ P 〈 0.05 ）, especially in PAS group（ P 〈0.01 ）. Carotid plaques scrore in PAS group was on a slight downward trend（ P 〉0.05 ）. Conclusions （ 1 ） The effects of combination therapy of probucol, atorvastatin and aspirin drugs of adjusting lipids and decreasing the level of inflammatory factor hs-CRP are better than that of combination therapy of probucol and atorvastatin. （2） Long-term further observation is demanded to draw a conclusion on the stability of carotid plaque.