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Objective To explore relationship between the nature of carotid atherosclerotic plaque and the number and function of endothelial progenitor cells in peripheral blood.Methods A prospective study of 80 carotid atherosclerotic plaque patients were selected from June 2016 to March 2017 in Guangdong Second Provincial General Hospital.All patients were examined with Cranial magnetic resonance imaging or X-ray computed tomography,pathological examination,carotid artery color Doppler ultrasonography.Patients were divided into hard plaque group (n =42) and soft plaque group (n =38) according to the nature of carotid atherosclerotic plaque.Forty healthy subjects were selected as controls.Monocytes were obtained from 10 ml of elbow venous blood by density gradient centrifugation.Adherent cells were cultured and identified by confocal laser microscopy.The number,migration,proliferation and adhesion of EPCs in soft plaque group and hard plaque group were evaluated.Results The number of proliferating cells (0.847 ± 0.037),migrating cells(27.697±8.248) and adherent cells (46.184± 7.876) in the normal control group were significantly higher than those in the hard plaque group ((0.647±0.019),(18.643±3.289),(32.165±4.325)) and the soft plaque group ((0.679± 0.023),(23.576± 6.327),(40.587±6.523)) (all P＜ 0.001),while the proliferation,migration and adherent cells in the hard plaque group were lower than those in the soft plaque group (all P＜0.001).Conclusion The nature of carotid atherosclerosis plaque is closely related to the number and function of endothelial progenitor cells in peripheral blood.The number of endothelial progenitor cells in carotid atherosclerosis patients with hard plaque is small,and their proliferation,migration and adhesion ability are impaired.
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Objective To observe the efficacy and safety of rosuvastatin in the treatment of hyperlipidemia and carotid atherosclerotic plaque in young ischemic stroke patients.Methods In prospective study,264 young ischemic stroke patients with hyperlipidemia and carotid atherosclerotic plaque were randomly divided into low dose group,middle dose group,high dose group,88 cases in each group.All patients were given rosuvastatin immediately after dinner,in doses of 5mg,10mg,20mg,respectively,for eight months.Then,the changes of hyperlipidemia and carotid atherosclerotic plaque in the three groups were surveyed,and its safety by the observation of clinical symptoms and monitoring of adverse reactions after eight months were assessed.Results Before treatment,the blood fat and carotid atherosclerosis plaque index in the three groups had no statistically significant differences (all P >0.05). After treatment,the total cholesterol,triglycerides,low -density lipoprotein cholesterol of the high dose group were (1.67 ±0.68)mmol/L,(3.23 ±0.53)mmol/L,(1.83 ±0.62)mmol/L,which of the middle dose group were (1.93 ±0.74)mmol/L,(3.73 ±0.23)mmol/L,(2.24 ±0.73)mmol/L,which of the low dose group were (2.16 ± 0.77)mmol/L,(4.06 ±0.93)mmol/L,(2.93 ±0.35)mmol/L.These indicators were decreased than before treat-ment [(2.79 ±0.72)mmol/L,(5.40 ±0.67)mmol/L,(3.64 ±1.03)mmol/L,(2.75 ±0.81)mmol/L,(5.59 ± 0.95)mmol/L,(3.43 ±0.92)mmol/L and (2.83 ±0.53)mmol/L,(5.84 ±0.79)mmol/L,(3.83 ±0.88)mmol/L].The decrease of the high dose group was higher than the middle and low dose group,the difference was statistically significant(F =6.61,P 0.05),and no serious adverse reaction was found.Conclusion The high dose rosuvastatin treatment can reverse the nature of plaque, decrease the thickness of the plaques and lower blood lipid of young ischemic stroke with hyperlipidemia and carotid atherosclerotic plaque,which is better than middle and low dose,and has better security.There is no serious adverse reaction.It is worth for clinical promotion.
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Objective: To investigate the effect of the combination of Yindan Xinnao Tong Soft Capsule (YXTSC) and atorvastatin, Clopidogre Tablets on blood lipid, carotid atherosclerosis (CAS) plaque, and the neurological function recovery in the patients of acute cerebral infarction with type 2 diabetes. Methods: One hundred and fifty patients (CAS plaque in them was confirmed by carotid artery color Doppler ultrasound) with acute cerebral infarction and diabetes in Tianjin Hospital during May form 2013 to 2015 were seleted and randomly divided into two groups, 75 cases in each group. On the basis of basic disease treatment for the patients in the two groups, the patients in the control group were given Atorvastatin Tablet of 10 mg/d and Clopidogre Tablets of 75 mg/d, orally once daily. On the basis of the control group treatment, the patients in the treatment group were given YXTSC (0.4 g/capsulae) three capsules once and three times daily. The patients in both groups were given diet control and their blood pressure, blood sugar, and other drug treatments were controlled according to the disease. The blood lipid level was observed before and after the treatment for 12 months in the two groups, the total number of CAS plaque was calculated, the plaque intima media thickness (IMT) was measured, and the nature of the change was determined. The neurological function score, curative effect judgment, and the statistics of the end events between the two groups were carried at the end of the treatment. Results: After the treatment, the serum TC, LDL-C, and TG were reduced, HDL-C of the patients in the two groups increased, while the LDL-C of the patients in the treatment group was lower than that of the patients in the control group significantly (P < 0.05); The IMT of the patients in the two groups was significantly lower than that of patients before the treatment, but the plaque area of the patients in the treatment group was smaller than that of the patients in the control group significantly (P < 0.05); The scores of nervous function of the patients in treatment group were significantly lower than those of the patients in the control group; The curative effect of the treatment group was better than that of the control group (P < 0.01). The incidence of adverse drug reactions in treatment group was lower than that in the control group (P < 0.05). Conclusion: The combination of YXTSC and atorvastatin could effectively treat hyperlipidemia and CAS plaque in cerebral infarction patients associated with type 2 diabetes.
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Objective To explore the effect of carotid atherosclerotic plaque ( CAP) on severity and recurrence of patients with cerebral infarction ( CI ) .Methods The prospective cohort study was utilized in this research. Existence and type of CAP were detected by Doppler ultrasound, and patients were divided into plaque group and without plaque group.The patients was evaluated by NIHSS on admission and 7 d, 14 d after admission, and patients were followed up for 1 year.The condition of CI recurrence was be observed.Results According to the Doppler ultrasound, patients were divided into plaque group ( 173 cases, 70.3%) and without plaque group ( 73 cases, 29.7%) .Compared with without plaque group, age, NIHSS score and incidences of hypertension, diabetes, hyperlipidemia, hyperfibrinogenemia were significantly increased (P<0.05 -0.01).In the patients who were conducted follow-up, cerebral infarction recurrence was in 39 cases (24.84%) in plaque group, recurrence time was 10.12 month.The recurrence time was 11.82 month in patient with non-vulnerable plaque, it was 10.62 month in patient with mixed plaque, and it was 9.13 month in patient with vulnerable plaque.Cerebral infarct recurrence was in 7 cases (10.45%) in without plaque group, recurrence time was 11.56 month.The recurrence rate in plaque group was significant increased than that in without plaque, however, the recurrence time for without plaque group was longer than that for plaque group ( all P<0.05 ) .The recurrence rate and recurrence time in patient with vulnerable plaque was significantly earlier than that in patient with non-vulnerable plaque (P=0.034).Conclusion The CAP in patients with acute CI can exacerbate the disease, and increase recurrence rate.It is especially in patients with vulnerable plaque.
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Objective To investigate the relationship between carotid atherosclerotic plaque and multiple risk factors of angiocardiopathy,and to evaluate the injuries caused by different risk factors to subclinical target organ to control the general risk factors of angiocardiopathy.Methods Four hundred and twenty six outpatients and impatients,treated in our hospital from May 2007 to May 2009 with the results of color ultrasonic examination,were divided into carotid atherosclerotic plaque group(284 cases) and no carotid atherosclerotic plaque group( 142 cases).The clinical information including their age,body mass index,smoking condition,past medical history such as hypertension,diabetes mellitus and hyperlipoidemia were recorded,and the levels of total cholesterol(T C),high density lipoprotein cholesterol( HDL-C),low density lipoprotein cholesterol(LDL-C),triglyceride (TG),lipoprotein ( a ) ( LP (a) ),apolipoprotein A - 1 ( Apo A 1 ),apolipoprotein B ( Apo B ),highsensitivity C-reactive protein( hs-CRP),homocysteine ( HCY),microalbuminuria( MAU ) and uricacid(UA) were determined by lab tests.The independent variable and univariable data were processed and analyzed statistically to find out the risk factors of carotid atherosclerotic plaque.Results Age and drinking were significantly correlated with the carotid intima-media wall thickening(IMT) (P ＜ 0.001 ).Overweight,diabetes mellitus,increased LP (a),hyperlipoidemia,age,increased MAU and HCY could independently predict carotid atherosclerosis and plaque formation ( x2 =71.35,38.45,t =3.26,x2 =37.23,t =118.51,6.723 and 3.17respectively,Ps ＜ 0.05 ).The aggregated number of the risk factors was correlated to IMT and carotid atherosclerotic plaque ( P =0.0001 ).Conclusion Age,drinking,overweight,diabetes mellitus,increased LP (a),hyperlipoidemia,MAU and HCY are risk factors of carotid atherosclerosis and plaque formation,and the contribution of each factor can multiply and overlap,more risk factors means greater risk.
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Objective To investigate the effects of Xuezhikang (XZK) on carotid atherosclerosis plaque and blood lipids in patients with transient ischemic attack (TIA). Methods 65 patients with TIA were randomly divided into two groups: XZK group and control group.XZK group received XZK and Aspirin for 6 months, while the control group received Aspirin only. The intima-midia thickness (IMT) of carotid artery,the area of carotid atherosclerosis plaque, and levels of blood lipids, oxidized low density lipoprotein cholesterol (ox-LDL) and serum nitric oxide (NO) were measured before and after treatment.Incidence rate of cerebrovascular event in the two groups were compared in 6 months. Results After 6 months of treatment, the total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and ox-LDL concentrations decreased significantly in XZK group, however high density lipoprotein (HDL) and NO levels increased markedly (all P0.05).Conclusion It is shown that XZK not only effectively adjusts blood lipids, inhibits peroxide of lipids and protects vascular endothelial, but also regresses the atherosclerosis and stabilizes the plaque.