Rosuvastatin Combined With Clopidogrel On The Degree Of Arterial Stenosis And The Level Of P-selectin In Patients With Ischemic Cerebral Vascular Disease Caused By Carotid Stenosis

ObjectiveAtherosclerosis (AS) is the basic cause of ischemic cerebral vascular disease. The occurrence and evolution of atherosclerosis is a low-level chronic inflammatory process. P-selectin, which represents the adhesion of inflammatory cells, is an important indicator of platelet activation in the ischemic cerebral vascular disease damage. Rosuvastatin is a new generation HMG-CoA reductase inhibitors. Rosuvastatin is one of lipid-modulating drugs. A large number of trials show that rosuvastatin has various non-lipid-modulating effects especially anti-inflammatory effect, stabilizing plaque, improving endothelial function. As is a new antiplatelet drug,clopidogrel can inhibit platelet aggregation and prevent thrombosis. At the same time, clopidogrel can also reduce the plasma level of P-selectin and have anti-inflammatory effect. Therefore, in theory, rosuvastatin combined with clopidogrel can lower the plasma level of P-selectin, inhibit inflammatory response and delay the process of atherosclerosis,thereby they can reduce cerebral vascular clinical events. In this study, through giving rosuvastatin and lopidogrel treatment to the patients with ischemic cerebral vascular disease caused by carotid stenosis, to explore the changes of carotid ultrasound and P-selectin, to evaluate the impact on cerebral vascular clinical events.MethodsNinety patients including 48men and 42 women(age:52.5-66.9 years old) with ischemic cerebral vascular disease caused by carotid stenosis were selected in this investigation. These patients were divided into three groups randomly. And all the patients received the detection of the carotid intima-media thickness (CIMT), artery plaque score,plaque area, stenosis rate, plasma levels of P-selectin."A"treatment group: to give clopidogrel(75mg qd);"B"treatment group: to give simvastatin (20mg qn)+ clopidogrel(75mg qd);"C"treatment group: to give rosuvastatin(10mg qn)+clopidogre(l75mg qd). Three groups in the control of blood pressure,glucose, smoking cessation, scavenging oxygen free radicals, improving circulation and so on are exactly the same. Another 30 normal persons were selected randomly as a normal control group, including 17men and 13 women(age:59.0±6.2 years old).All the normal persons received the detection of the carotid intima-media thickness (CIMT), artery plaque score,plaque area, stenosis rate, plasma levels of P-selectin. For all the patients with ischemic cerebral vascular disease,the plasma level of P-selection was measured after 8 weeks of treatment,and the neck vascular ultrasound was reviewed to observe the change of carotid intima-media thickness (CIMT), artery plaque score,plaque area, stenosis rate after 6 months of treatment. Thus the two drugs on the impact of ischemic cerebral vascular disease could be known.ResultsThe plasma level of P-selection,CIMT,artery plaque score, plaque area,and lumen stenosis rate of the patients with ischemic cerebral vascular disease were significantly higher than the normal persons. These differences were statistically significant(P<0.01). The plasma level of P-selectin, CIMT, artery plaque score,plaque area, and lumen stenosis rate were no statistical differences before treatment in the three treatment groups (P>0.05). After treatment, the plasma level of P-selection,CIMT,artery plaque score,plaque area,and lumen stenosis rate were significantly lower than before. These differences were significant(P<0.05). There were statistical differences between"C"treatment group and"A"treatment group, " C"treatment group and "B"treatment group after treatment(P <0.05).ConclusionsRosuvastatin combined with clopidogrel can lower the plasma level of P-selectin level, alleviate the inflammation within the atherosclerotic plaque,reduce the plaque area, reduce the degree of vascular stenosis,and delay the process of atherosclerosis.This study provide a theoretical basis for the treatment of ischemic cerebral vascular disease. Because of the small sample size, the short follow-up period, this conclusion need to be futher confirmed by large-scale clinical trials.