目的 觀察葛根素注射液聯(lián)合阿托伐他汀鈣治療頸動脈粥樣斑塊的臨床療效及其安全性，為指導(dǎo)臨床合理用藥提供參考依據(jù)。方法 選取2016年1月-2017年6月河南科技大學第一附屬醫(yī)院收治的86例頸動脈粥樣斑塊患者，采用隨機數(shù)表法將患者分為對照組和治療組，每組各43例。對照組患者口服阿托伐他汀鈣片，20 mg/次，1次/d。治療組患者在對照組基礎(chǔ)上于每個療程前10天靜脈滴注葛根素注射液，0.4 g加入5%葡萄糖500 mL，1次/d。兩組患者均治療3個月。觀察兩組的臨床療效，比較兩組患者治療前后總膽固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL-C）水平，內(nèi)皮素1（ET-1）、血栓素（TXB₂）、一氧化氮（NO）、超敏C反應(yīng)蛋白（hsCRP）水平和頸動脈中層內(nèi)膜厚度（IMT）值、頸動脈內(nèi)徑（CAD）及斑塊面積、斑塊積分的變化情況。結(jié)果 治療后，對照組和治療組的總有效率分別為72.09%和90.70%，兩組比較差異具有統(tǒng)計學意義（P<0.05）。兩組患者TC、TG和LDL-C水平均比治療前顯著降低，同組治療前后比較差異具有統(tǒng)計學意義（P<0.05）；且治療后治療組TC、TG和LDL-C水平明顯低于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。兩組患者ET-1、TXB2、hsCRP水平明顯降低，NO水平明顯升高，同組治療前后比較差異具有統(tǒng)計學意義（P<0.05）；且治療后治療組ET-1、TXB2、hsCRP、NO水平明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。頸動脈斑塊面積、斑塊積分均明顯降低，同組治療前后比較差異具有統(tǒng)計學意義（P<0.05）；且治療組患者頸動脈斑塊面積、斑塊積分均明顯低于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。結(jié)論 葛根素注射液聯(lián)合阿托伐他汀鈣療效顯著，可有效改善頸動脈粥樣斑塊硬化患者的血脂及血管內(nèi)皮因子水平，降低斑塊積分，保護血管內(nèi)皮，安全性高，具有一定的臨床推廣應(yīng)用價值。

Objective To observe the clinical efficacy and safety of Puerarin Injection combined with atorvastatin calcium in treatment of carotid atherosclerotic plaque, so as to provide reference for clinical rational drug use. Methods Patients (86 cases) with carotid atherosclerotic plaque in the First Affiliated Hospital of Henan University of Science and Technology from January 2016 to June 2017 were randomly divided into control group and treatment groups, and each group had 43 cases. Patients in the control group were po administered with Atorvastatin Calcium Tablets, 20 mg/time, once daily. Patients in the treatment group were iv administered with Puerarin Injection on the basis of the control group, 0.4 g added into 5% Glucose Injection 500 mL, once daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacy were evaluated, the total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C) levels, endothelin 1 (ET-1), thromboxane (TXB₂), nitric oxide (NO), high sensitive C reactive protein (hsCRP) levels, and intima-media thickness (IMT), carotid artery diameter (CAD), plaque area and plaque score in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 72.09% and 90.70%, respectively, and there were differences between two groups (P < 0.05). TC, TG, and LDL-C levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the TC, TG, and LDL-C levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). ET-1, TXB₂, and hsCRP levels in two groups were significantly decreased, but NO level were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And those levels in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Plaque area and plaque score in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And those indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Puerarin Injection combined with atorvastatin calcium has good effect in treatment of carotid atherosclerotic plaque, can effectively improve the blood lipid and vascular endothelial growth factor levels, reduce plaque and protect endothelial cells, with good safety, which has a certain clinical application value.