The Relationship Between Carotid Atherosclerosis And Coronary Heart Disease And Therapy Study Of Atorvastatin In Patients With Coronary Heart Disease

OBJECTIVE:CDTo investigate the intima-media thickness(IMT) and plaques on carotid artery, and evaluate the relationship between coronary heart disease(CHD), at the same time, to analyze risk factors of CHD. ㏕o investigate the dilatation changes of brachial arteries during reactive hyperemia and after sublingual administraction of glyceryl trinitrate(GTN).(3)To explore the role and clinic value of inflammation in patients with unstable angina pectoris (UAP).?To study the effect of atorvastatin on inflammation, endothelial function and postponing progression of atheromatous plaques.METHODS: ︰sing B-mode ultrasonography, measuring the intimia--media thickness of carotid artery and analyzing risk factors of CHD on 90-3-patients with CHD,and 30 subjects with normal coronary arteries (Control). (D Using B-mode ultrasonography, measuring the dilatation of brachial arteries during reactive hyperemia and after sublingual administraction of glyceryl trinitrate(GTN). To investigate endothelium dilatation changes after 10-12 weeks' treatment of atorvastatin, and improvement of carotid atherosclerosis after 9 months'treatment of atorvastatin, including IMT, plaques and Integrated backscatter(IBS)(3) Plasma levels of CRP, IL-6, IL-10 and sICAM-1 were determind in patients with unstable angina pectoris (UAP) and patients with stable angina pectoris (SAP) using enzyme linked immunosorbent assay(ELISA). @ Patients with unstable angina received oral atorvastatin lOmg for 10-12 weeks.RESULTS: ?The intimia-media thickness of CHD group was significantly higher than those of the control group, and had no significant variance of the 1,2,3-vessel group. Atherosclerotic plaques were found mostly in the carotid bifurcation and common carotid artery segments. The discovery rate was greater in 2,3-vessel group. The content of TC, LDL-C and incidence rate of hypertension, diabetes mellitus were higher in CHD group. (2) The flow-mediated dilatation and GTN-induced dilatation of brachial arteries in patients with CHD were significantly reduced as composed with those in control group (P<0.01) .?Plasma levels of CRP, IL-6 and sICAM-1 are significantly higher in patients with UAP than those in patients with SAP (P<0.05 ) and health controls ( P<0.05 ) , but no difference between the latter two groups(P>0.05) .Plasma level of IL-10 is singinficantly lower in patients with UAP than those in patients with SAP (P<0.05) , but higher than health controls(P<0.05) .? After treatment of atorvastatin, the endothelial function of patients-4-significantly (P<0.05) .the average levels of CRP, IL-6, sICAM-1 were lowed significantly (P<0.05) , IL-10 tightened (P<0.05) . There is no significant improvement in plaques, but ther is significant decrease of IMT (PO.05). There is a increseing tendency of IBS of carotid atherosclerosis (P>0.05). Maybe that is related to short time of investigation and a small quantity of cases.CONCLUSION: ?CHD is associated with a higher incidence of and more extensive atherosclerosis in carotid artery. Using B-mode ultrasonography on carotid artery has definitely prognosticative value for CHD. ?) During patients with CHD and persons with CHD risk factors, Using B-mode ultrasonography to investigate atherosclerosis in carotid artery and the endothelial function, these methods can provide evidences of CHD in earlier period, also can monitor patient's condition and prognosis. ? Patients with unstable angina have high levels of CRP, IL-6 and sICAM-1, all these hint that inflammation plays an important role in unstable angina. ?The results demonstrate that atorvastatin has the role of anti-inflammation, postponing progression of atheromatous plaques and improving the endothelial function.