Effect of intensive lipid-lowering therapy on carotid artery intima-media thickness and plaque area in patients with acute cerebral infarction
Objective To investigate the effect of intensive lipid-lowering therapy on carotid artery intima-media thickness and plaque area in patients with acute cerebral infarction.Methods Eighty-two patients with acute cerebral infarction who received treatment at the Changzhi Mental Health Center from July 2021 to July 2022 were included in this study.Using a randomized controlled trial design,the patients were randomly divided into an intensive treatment group(n=41)and a conventional treatment group(n=41)using the random number table method.All patients had surpassed the recommended time window for thrombolysis and were given conventional treatments,including antiplatelet aggregation and neuroprotection.The conventional treatment group received conventional lipid-lowering therapy,while the intensive treatment group underwent intensive lipid-lowering therapy.All treatments lasted 6 months.The levels of blood lipids(low-density lipoprotein cholesterol and total cholesterol),inflammatory factors(C-reactive protein and interleukin-6),and atherosclerosis indicators(carotid artery intima-media thickness and plaque area)were measured and compared between the two groups before and after treatment.Adverse reactions occurring during the treatment period,including myalgia,nausea,vomiting,and abnormal liver function were also recorded.Results Before treatment,there were no significant differences in blood lipids,inflammatory factors or atherosclerosis indicators between the conventional treatment and intensive treatment groups(all P>0.05).After treatment,the levels of low-density lipoprotein cholesterol and total cholesterol in the intensive treatment group were significantly lower than those in the conventional treatment group[(3.44±0.42)mmol/L vs.(4.81±0.53)mmol/L,(3.46±0.35)mmol/L vs.(2.41±0.27)mmol/L,t=12.97,15.21,both P<0.05].After treatment,serum levels of interleukin-6 and C-reactive protein in the intensive treatment group were significantly lower than those in the conventional treatment group[(4.79±0.53)mg/L vs.(6.97±0.81)mg/L,(38.45±4.14)pg/L vs.(49.66±5.07)pg/L,t=14.42,10.97,both P<0.05].Carotid artery intima-media thickness and plaque area in the intensive treatment group were significantly smaller than those in the conventional treatment group[(0.98±0.10)mm vs.(1.17±0.12)mm,(13.04±1.37)mm2 vs.(17.96±1.89 mm2,t=7.79,13.50,both P<0.001).There was no significant difference in the overall incidence of adverse reactions during treatment between the intensive treatment and conventional treatment groups(P>0.05).Conclusion Intensive lipid-lowering therapy is highly effective in patients with acute cerebral infarction.It can reduce inflammatory reactions,delay the progression of atherosclerosis,and provide a safety profile similar to that of conventional lipid-lowering therapy.