| Objectives: The main mechanism of ischemic cerebrovascular disease is atherosclerotic plaque rupture and thrombosis, in which inflammation and platelet activation play a crucial role. The P-selectin is quite important in the initiation of inflammatory response, and it can mediat leukocyte adhering and aggregating to the endotheliocyte, accelerate the process of thrombosis. Statin drugs are widely used as clinical lipid-regulating drugs. Recent studies have found that statins also can inhibit inflammatory response, restrain proliferation and apoptosis of smooth muscle cell, anti-platelets, inhibit intravascular plaque generation, etc. It has been found that statins can reduce high sensitivity C-reactive protein level, whether they are involved in other aspects of plaque inflammation require in-depth study . The research intend to reveal the effect of lower doses (20mg) atorvastatin calcium on P-selectin and lipid levels in blood serum of the patients with carotid artery plaque, in order to understand the internal mechanism of atorvastatin calcium's effect on plaque.Methods: 1 Object: Seventy-nine patients who were confirmed as carotid artery plaque with color Doppler ultrasound in the first hospital of Hebei Medical University were included in this study in January 2006–October 2008. Thirty patients without carotid artery plaques confirmed by color Doppler ultrasound as a non-plaque group. 2 Methods: The plaque group were divided into atorvastatin calcium treatment group (treatment group, 43 cases) and control group( 36 cases).The treatment group were given atorvastatin calcium 20mg 1/d and with enteric-coated aspirin 75mg 1/d, control group was given enteric-coated aspirin 75mg 1/d, and according to the condition of patients, blood sugar and blood pressure were controlled, dietary control performed in both groups. Observe the P-selectin and lipid levels before treatment and 6 months, 18months after treatment respectively, meanwhile, primary end point and adverse reaction were recorded. Non-plaque group was not given to interventions, without clinical observations, only left the blood for control study. Statistics analyses were performed by SPSS 11.5 software. The statistics of count data usedχ2 test , blood lipids and plaque of each time points in the inter-group used single-factor analysis of variance (ANOVA), comparison between the two groups at each time point used independent samples t-test, P < 0.05 was considered statistically significant.Results: P-selectin levels in non-plaque group were lower than the plaque group before treatment, the difference was statistically significant. End incidences of the treatment group and control group were not significantly different. P-selectin levels were significantly lower at 6 months and 18 months after atorvastatin treatment compared with before treatment(P<0.05). The P-selectin level of 18 months compared with 6 months had a downward trend, but without significantly differentce (P>0.05).There was no significant difference in the control group on P-selectin levels in the 18-month observation period(P>0.05). From the 6 months the blood cholesterol, low-density lipoprotein levels of the treatment group were significantly lower compared with those before treatment, the difference was statistically significan(tP<0.05), and with the extension of treatment time they decreased, the triglyceride levels of the treatment group decreased at the 18 months, high - density lipoprotein increased, compared with those before treatment the difference was statistically significant(P<0.05). In the control group, the blood lipid indicators in 18 months observation period had no significant difference(P>0.05). There were no serious side effects in treatment group.Conclusions: P-selectin and blood lipids in patients with carotid artery plaque have a high level than those without plaque. Atorvastatin calcium can reduce the P-selectin ,blood cholesterol, low-density lipoprotein and triglyceride levels, while decrease the elevated high-density lipoprotein level. 20mg atorvastatin calcium can not only regulate the blood lipids, but also by inhibiting inflammatory mediators P-selectin to inhibit the inflammatory response, anti-platelet, improve endothelial function,stable the plaque, thus preventing the occurrence of ischemic cerebrovascular disease .
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