Abstract: Background　Carotid atherosclerosis is a local manifestation of systemic atherosclerosis.Active and effective preventive measures can effectively reduce the incidence of ischemic cardiovascular and cerebrovascular diseases.Atorvastatin calcium tablet can delay the development of atherosclerotic plaques by lowering lipid，but the effect is slow.In recent years，Chinese Traditional Medicine has been widely used in the treatment of cardiovascular and cerebrovascular diseases.Clinical study on the efficacy of compound danshen dropping pills combined with atorvastatin in the treatment of atherosclerosis is not very in-depth.Objective　To explore the effects of compound danshen dropping pill combined with atorvastatin on plasma pentraxin 3（PTX3） and related indexes of carotid atherosclerotic plaques in patients with carotid atherosclerosis（CAS）．Methods　According to the random number table，156 patients with CAS admitted to Harrison International Peace Hospital from March 2016 to February 2018 were divided into control group and research group，with 78 cases in each group.Patients in the control group were given atorvastatin calcium orally，two tablets/time，one time/day，while those in the research group with compound danshen dripping pill，10 pills/time，three times/day，on the basis of treatment in the control group.The course of treatment was two weeks.The clinical efficacy of the patients after treatment was counted.The levels of PTX3，blood lipid〔total cholesterol（TC），triglyceride（TG），low density lipoprotein cholesterol（LDL-C） and high density lipoprotein cholesterol（HDL-C）〕，endothelial function〔nitric oxide（NO） and vascular endothelin 1（ET-1），soluble intercellular adhesion molecule-1（sICAM-1），thromboxane B2（TXB2）〕 and carotid artery color Doppler flow imaging〔carotid intima-media thickness（IMT），carotid artery diameter（CAD） and carotid atherosclerosis plaque area（CASPA） and integral〕 were detected before and after the treatment.The occurrence of adverse reactions was also observed.Results　The clinical efficacy of the research group was significantly higher than that of the control group（u=2.020，P=0.043）．Compared with indicators before treatment，the levels of plasma PTX3，TC，TG and LDL-C significantly decreased in the two groups after treatment（P<0.05），while HDL-C level significantly increased（P<0.05）．After treatment，the serum NO level in two groups was significantly higher than that before treatment（P<0.05），while the levels of serum ET-1，sICAM-1 and TXB2 were significantly lower than those before treatment（P<0.05）．The IMT，CAD，CASPA and plaque integral in both groups after treatment were significantly lower than those before treatment（P<0.05）．No adverse reactions were observed in all patients during treatment.There was no significant change in liver and kidney function indexes.Conclusion　Compound danshen dripping pill combined with atorvastatin can not only effectively improve the plasma PTX3 level in CAS patients，but also stabilize blood lipids，vascular endothelial function and plaque parameters.As being safe as well.

Key words: Atherosclerosis, Compound danshen dropping pill, Atorvastatin, Pentraxins3, Dyslipidemias, Vascular endothelium

摘要： 背景　颈动脉粥样硬化（CAS）是全身动脉粥样硬化的局部表现，采取积极有效的防治措施能够有效降低缺血性心脑血管疾病的发病率。阿托伐他汀钙片通过降脂而延缓动脉粥样硬化斑块的发展，但其作用缓慢。近年来中医药广泛应用于心脑血管疾病的治疗中，临床上对于复方丹参滴丸联合阿托伐他汀治疗动脉粥样硬化的疗效研究并不是很深入。目的　探讨复方丹参滴丸联合阿托伐他汀治疗CAS的疗效，分析血浆正五聚蛋白3（PTX3）及颈动脉粥样硬化斑块相关指标的变化。方法　选择2016年3月—2018年2月哈励逊国际和平医院门诊和住院部收治的CAS患者156例，根据随机数字表法将患者分为对照组和研究组，每组78例。对照组给予口服阿托伐他汀钙，2片/次，1次/d，连续用药2周。研究组在对照组基础上联用复方丹参滴丸，10粒/次，3次/d，连续用药2周。观察患者治疗后的临床疗效，分别于治疗前后检测患者血浆PTX3、血脂〔总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）〕、血管内皮功能〔一氧化氮（NO）、血管内皮素-1（ET-1）、可溶性细胞间黏附分子-1（sICAM-1）、血栓素B2（TXB2）〕，并记录颈动脉彩色多普勒超声〔颈动脉内膜中层厚度（IMT）、颈动脉内径（CAD）、颈动脉硬化斑块面积（CASPA）和斑块积分〕指标；观察患者治疗期间不良反应的发生情况。结果　研究组临床疗效好于对照组（u=2.020，P=0.043）；治疗后两组患者血浆PTX3、TC、TG及LDL-C均低于治疗前（P<0.05），HDL-C高于治疗前；治疗后研究组PTX3、TC、TG及LDL-C均低于对照组，HDL-C高于对照组（P<0.05）。治疗后两组患者血清NO高于治疗前，ET-1、sICAM-1及TXB2低于治疗前（P<0.05）；治疗后研究组NO高于对照组，ET-1、sICAM-1及TXB2低于对照组（P<0.05）。治疗后两组患者IMT、CAD、CASPA及斑块积分低于治疗前（P<0.05）；治疗后研究组IMT、CAD、CASPA及斑块积分低于对照组（P<0.05）。两组患者在治疗过程中未出现严重的不良反应，肝肾功能指标无明显变化。结论　复方丹参滴丸联合阿托伐他汀不仅能够有效改善CAS患者血浆PTX3水平，而且能够稳定血脂、血管内皮功能及斑块参数。

关键词: 动脉粥样硬化, 复方丹参滴丸, 阿托伐他汀, 正五聚蛋白3, 血脂异常, 血管内皮