|
Background With the aging of our population, the incidence of atherosclerosis, ischemic heart and cerebrovascular diseases gradually increased and has now become one of the leading cause of death of the Chinese population. It is predicted that 2050 will be the first cause of death in the world within atherosclerotic The prevention and treatment of atherosclerosis has been a hot research topic in the cardiovascular field. A large number of animal experiments at home and abroad have confirmed that grape seed proanthocyanidins (grape seed proanthocyanidin extract, GSPE) has a strong anti-inflammatory, antioxidant, protecting the role of vascular endothelial and other shows significant anti-atherosclerotic effect. However, clinical studies about The GSPE intervention carotid atherosclerosis has not been reported. Research purposes through clinical studies to observe the application of GSPE intervention on patients with carotid artery atherosclerosis treatment effect, and to explore its possible mechanism of action, and to seek new artery atherosclerosis prevention drugs provide the scientific basis. A study of the research methods selected by color Doppler ultrasound confirmed 157 cases of patients with carotid atherosclerosis were randomly divided into two groups: GSPE group and the control group. 81 cases of the control group, given the lifestyle intervention; that GSPE holds substantial promise for the treatment of DN, and GSPE group (76 cases), on the basis of the same lifestyle intervention, oral administration of grape polyphenol capsules (Tianjin Jianfeng Natural Product Research and Development Co., Ltd., proanthocyanidins OPC content: 100mg / tablets) 2 each time, twice a day. Throughout the follow-up to last 24 months. History taking and physical examination of all patients caught a detailed record basic information on age, sex, smoking history, medical history, cardiovascular and cerebrovascular diseases and family history, and record heart rate, blood pressure, height, weight and calculated body mass index (bodymass index BMI), and electrocardiogram and routine examination and physical examination. 3 serological examination all subjects before treatment and 6, 12, and 24 months after treatment to fasting venous blood, serum total cholesterol (total cholesterol, TC), triglycerides (triglyceride, TG), high density lipoprotein protein - cholesterol (high density lipoprotein cholesterol, HDL-C), low-density lipoprotein - cholesterol (low density lipoprotein cholesterol, LDL-C) concentration (mmol / L) and high-sensitivity C-reactive protein (high-sensitive C-reactive protein, hs-CRP) level (mg / L) 4 carotid ultrasound uses high-resolution color Doppler ultrasonic testing all patients before and after treatment, 6,12,24 a monthly average maximum carotid intima thickness ( The mean maximum carotid intima-media thickness, MMCIMT), plaque score and change in plaque stability. 5 Statistical analysis SPSS13.0 statistical software for statistical analysis, the measurement data are presented as mean ± standard deviation (x ± s), said the groups were compared using two-sample t-test, paired t-test was used to compare the groups. Count data were expressed as a percentage, comparing the chi-square test. P lt; 0.05 was considered statistically significant. Results of 157 patients completed 24 months of follow-up, the control group, 76 cases, 81 cases, GSPE group. The two groups of patients before treatment, no significant differences in gender, age, body mass index, blood pressure, blood biochemical indicators and past medical history. 2. Treatment was no significant difference between the two groups before the TC, TG, LDL-C and HDL-C levels. GSPE group patients after treatment TC, TG, LDL-C water average decline, but the difference was not statistically significant in the group; HDL-C levels 6 months of treatment was significantly higher (P lt; 0.05). Lipid levels of the control group had no significant change over time. Group comparison, only HDL-C treatment for 12 months a significant difference (P lt; 0.05) 3. Treatment of the former two groups of hs-CRP level without significantly with differences, treatment 6 months GSPE group hs-CRP that significantly with the decline, compared with before treatment 2.44mg / L (P lt; 0.05), while the control group hs-CRP showed a higher trend after 12 months was significantly higher (P lt; 0.05). The two sets of hs-CRP levels after 6 months of treatment that a significant difference (P lt; 0.05). 4. Before treatment two groups were MMCIMT, plaque score comparison, the difference was not statistically significant (P gt; 0.05). After treatment the the GSPE group patients MMCIMT significantly thinned, a significant reduction in plaque score. The GSPE group therapy before treatment to 12 months in patients with MMCIMT decreases 6.2% (P lt; 0.05), plaque score reduced by 10.9% (P lt; 0.05) 6 months of treatment, and with the time of treatment, the patient MMCIMT reduce further plaque score. The control group patients MMCIMT and the plaque score gradually increased with time. Comparison between groups, the treatment of the two groups of patients 6 months MMCIMT p lt; 0.05, two groups of plaque score p lt; 0.01 5 the two groups before treatment, the number of unstable plaques compared, the difference was not statistically significant (P gt; 0.05). The GSPE group's total number of patches and the number of unstable plaque were reduced after treatment, increased the total number of patches of the control group and the number of unstable plaque. Conclusion and significance of grape seed proanthocyanidins have significant anti-atherosclerotic effects can significantly reduce atherosclerosis in patients with carotid artery intima thickness, stability, reduce or even disappear plaque, and with time, GSPE anti- atherosclerotic effect is more obvious. GSPE can reduce the incidence of cardiovascular and cerebrovascular events. GSPE produce this anti-atherosclerosis effect is not dependent on the lipid changes may be related to anti-inflammatory, antioxidant, scavenging oxygen free radicals related. The GSPE possible atherosclerosis in asymptomatic atherosclerosis in patients with a new therapeutic drugs, a new choice for the primary prevention of atherosclerosis. Background With the continuous development of the socio-economic, lifestyle changes and the progress of the aging population, the incidence and mortality of our country and the world the heart and cerebrovascular diseases are rising, and has become a serious threat to human survival and life quality of major public health problem. Atherosclerosis is a major pathological basis of these cardiovascular and cerebrovascular diseases. It is predicted that 2050 will be the first cause of death in the world within atherosclerotic The statins are widely used in the secondary prevention of atherosclerosis, the curative effect. But it's adverse reaction to limit its clinical application. To find a safe and effective new drugs to combat atherosclerosis is a problem to be solved in clinical. A large number of animal experiments at home and abroad have confirmed that grape seed proanthocyanidins (grape seed proanthocyanidin extract, GSPE) has a strong anti-inflammatory, antioxidant, protecting the role of vascular endothelial and other shows significant anti-atherosclerotic effect. However, clinical studies about The GSPE intervention carotid atherosclerosis has not been reported. Objective To observe the combination GSPE and atorvastatin Ting after intervention for patients with carotid artery atherosclerosis treatment effects, and to explore its possible mechanism of action, and to provide a scientific basis for seeking new atherosclerosis atherosclerotic therapies. Research methods object selection by color Doppler ultrasound examination found that the presence of carotid atherosclerosis in patients with hyperlipidemia 122 cases were randomly divided into A, B groups. A group for statin treatment group, given atorvastatin 20mg night orally once; B group for the combined treatment group, given atorvastatin 10mg orally once a night grape polyphenol capsules (Tianjin Jianfeng Natural Product Research and Development Co. proanthocyanidins OPC content: 100mg / tablets) two at a time, twice a day. The entire study duration of 12 months. History taking and physical examination of all patients are detailed records of age, sex, smoking history, medical history, cardiovascular and cerebrovascular disease, family history and other risk factors, heart rate, blood pressure, measuring record height, weight and calculated body mass index (bodymass index, BMI ). The 3 serological examination all subjects were taken before and after treatment fasting venous blood, determination of serum total cholesterol (total cholesterol, TC), triglycerides (triglyceride, TG), low-density lipoprotein - cholesterol (low density lipoprotein cholesterol, LDL -C), high-density lipoprotein - cholesterol (high density He Liqun Cao cholesterol, HDL-C) concentration (mmol / L) and high-sensitivity C-reactive protein (high-sensitive C-reactive protein, hs-CRP) levels (mg / L) . Outpatient and re-admission, three months, six months, the cases were followed up for 12 months. The carotid ultrasound uses high-resolution color Doppler ultrasound to detect all patients before treatment and after 3, 6, and 12 months, the average maximum carotid intima thickness (mean maximum carotid the intima-media thickness, MMCIMT) plaque score and plaque stability change. 5 Statistical analysis SPSS13.0 statistical software for statistical analysis, the measurement data are presented as mean ± standard deviation (x ± s), said the groups were compared using two-sample t-test, paired t-test was used to compare the groups. Count data rate said, comparing the chi-square test. P lt; 0.05 was considered statistically significant. Results of 122 patients completed 12 months of follow-up, 59 cases of A group (63 cases), B group. The two groups of patients before treatment, no significant differences in age, sex, BMI, blood pressure, blood biochemical parameters, smoking history and past medical history and other aspects. The two groups of patients with serum TC, TG, LDL-C and HDL-C levels before treatment no statistically significant difference. The two groups of patients serum TC, TG, LDL-C level than before treatment, after 3 months of treatment was significantly lower (P lt; 0.001), HDL-C levels were significantly elevated. Group B than group A TG, TC, LDL-C levels decreased more significantly, the difference between the same point in time group had no statistical significance (P gt; 0.05); HDL-C levels compared to the same time points after treatment between the two groups, 6 months of treatment appear significantly different (P lt; 0.05). Before the two groups of patients with serum hs-CRP levels before treatment no statistically significant difference (P gt; 0.05) A serum hs-CRP concentration than treatment after 3 months of treatment, reduce 1.71mg / L (P lt; 0.05) B serum hs-CRP concentrations than before treatment to reduce 3.55mg / L (P lt; 0.05), a significant difference (P lt; 0.05) between the two groups compare serum hs-CRP levels after 6 months of treatment, and As the time of treatment, the difference further increase (12 P lt; 0.01) before treatment two groups were MMCIMT and plaque score had no significant difference. After treatment MMCIMT significant thinning of the plaque score were significantly lower. Group B than in group A change is more obvious. Comparison between groups, MMCIMT and plaque score in 6 months, a significant difference (P lt; 0.05), with the duration of treatment, the two groups MMCIMT and plaque score differences further increase (group between 12 months, P lt; 0.01) before treatment, the number of unstable plaques compared, the difference was not statistically significance (P gt; 0.05). After treatment, the total number of patches of the two groups of patients, and the number of unstable plaques were reduced B group decreased more significantly. Conclusion and significance of atorvastatin or has a clear anti-atherosclerotic effect with GSPE associated with statins single can significantly reduce the thickness of the carotid intima stable, shrink or even regression of plaque; patients can reduce hs-CRP level. Both associated with better efficacy, and found no adverse reactions, is worthy of clinical
|