Comparing Atorvastatin Combined With Probucal And Atorvastatin Monotherapy On The Effect Of Carotid Atherosclerotic Plaques By Contrast-enhanced Ultrasound

Objective: To compare atorvastatin combined with probucal and atorvastatin monotherapy on the effect of carotid atherosclerotic plaque’s vulnerability of hospitalized patients with ICVD by contrast-enhanced ultrasound.Comparing these two treatment methods on the effect of the recurrence rate of ICVD,clinical improvement and their operational abilities,thus we can make a dynamic evaluation and ordination of the clinical efficacy of two treatment method.To compare the advantages and disadvantages of conventional and contrast-enhanced ultrasound in the diagnosis of carotid atherosclerotic plaques by comparing their imaging results.Methods: Screening and collecting 68 hospitalized patients,with ICVD confirme by MRI,admitted to the Second Affiliated Hospital of Hebei Medical University,Department of Neurology from July 2015 to December2016.Conventional and contrast-enhanced ultrasound were performed for everyone and they are all out of contraindications and have signed the informed consent.The patients were randomly divided into two groups of A and B by flipping the coin.There are 33 patients in Group A and 35 patients in Group B.Group A were given atorvastatin 20 mg QD,probucal 0.25 g BID and conventional treatment as well.Group B were given atorvastatin 20 mg QD and other conventional treatment.Contrast-enhanced ultrasound was performed for patients after 4 months.We compare,observe and analysis the results of carotid artery ultrasound,NIHSS score and the recurrence rate of ICVD before and after treatment.We also analysis the results of conventional and contrast-enhanced ultrasound to compare the advantages and disadvantages of them.Results:1 Comparation of carotid atherosclerotic plaque vulnerabilityCompared with Group B,Group A reduced the level of plaque vulnerability more significantly after four months’ treatment.The difference was statistically significant.2 Comparation of NIHSS scoreBoth Group A and Group B reduced the NIHSS score significantly after four months’ treatment.There was no statistically significant difference between them.3 Comparation of the recurrence rate of ICVDAfter four months’ treatment,the recurrence rate was 3.3%(1 case)and16.7%(5 cases)in Group A and Group B.The rate of Group A was lower than Group B.The difference was statistically significant.4 Comparation between conventional and contrast-enhanced ultrasoundFrom the 60 patients,there are 8 patients whose contrast-enhanced ultrasound showed the plaque only for LevelⅠbut conventional ultrasound showed low echo plaques;8 patients whose contrast-enhanced ultrasound showed the plaque for Level Ⅲ~Ⅳ but conventional ultrasound showed high echo plaques;4 patients whose contrast-enhanced ultrasound shows the plaque of internal carotid lateral wall clearly where conventional ultrasonic cannot explore clearly.Conclusion:The curative effect of atorvastatin combined with probucal is better than atorvastatin monotherapy in the following aspects: stabilize carotid atherosclerosis plaque,improve clinical symptoms,operational abilities and prevent the recurrence rate of ICVD.In the diagnosis of level of carotid atherosclerotic plaques’ vulnerability,especially exploration plaque of the lateral wall of carotid artery,contrast-enhanced ultrasound is superior to conventional ultrasonic.