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Abstract: An elderly female patient came to our hospital with “paroxysmal dizziness for more than 1 month”. She had suffered from hypertension for more than 10 years and diabetes mellitus for more than 10 years, and was under treatment with oral antihypertensive drugs and subcutaneous insulin injections. The ultrasound examination revealed atherosclerotic plaque formation in the carotid artery, and the patient was treated with Rosuvastatin calcium tablets.
Basic information】Female, 70 years old
Disease Type】Carotid atherosclerosis, cerebral blood supply insufficiency, hypertension grade 3, type 2 diabetes mellitus
Hospital】Harbin Infectious Disease Hospital
Consultation Time】November 2019
Treatment plan] Oral Rosuvastatin calcium tablets, Ginkgo biloba
Treatment Period】8 days of inpatient treatment, 3 months of outpatient follow-up
Treatment effect】The dizziness was relieved in 8 days of hospitalization, and the atherosclerotic plaque was significantly reduced in about 3 months when the carotid ultrasound was repeated.
I. Initial consultation
She has been suffering from hypertension for more than 10 years, with the highest blood pressure exceeding 180/110 mmHg. She has been suffering from type 2 diabetes mellitus for more than 10 years, and her blood pressure has been maintained at about 150/90 mmHg with oral antihypertensive drugs and subcutaneous insulin injections. mmol/L, postprandial blood glucose was basically stable. The preliminary diagnosis was carotid atherosclerosis, cerebral insufficiency, hypertension grade 3, and type 2 diabetes mellitus.
II. Treatment history
After the diagnosis of carotid artery atherosclerosis was confirmed by carotid ultrasound, the patient followed the doctor’s advice, and after discussion with her family, she was promptly hospitalized and agreed to use Rosuvastatin calcium tablets for treatment, along with other medications to improve microcirculation, such as Ginkgo biloba. At the same time, blood pressure and blood glucose were monitored daily, and the use of antihypertensive and hypoglycemic drugs was standardized. After 8 days of hospitalization, the patient’s dizziness was relieved, and her blood pressure and blood glucose were basically stable, and she reached the discharge criteria.
III. Treatment effect
After 8 days of hospitalization and care, the patient’s dizziness was relieved and her blood pressure and blood glucose were stabilized, so she was discharged on the same day. After discharge, the patient was instructed to continue to take Rosuvastatin calcium tablets for treatment and to review the patient’s condition at the outpatient clinic in 3 months. Through standardized medication, blood pressure and blood glucose were also basically stable without major fluctuations at ordinary times.
IV. Precautions
However, since atherosclerosis still exists, the patient is advised to continue taking Rosuvastatin calcium tablets for long-term treatment after discharge from the hospital. At the same time, he needs to adjust his lifestyle, eat a low-salt and low-fat diet, combine work and rest, exercise properly, quit smoking and alcohol, and keep his blood pressure and blood sugar in a stable state. Regularly review the carotid ultrasound, and if necessary, review the blood lipids and head CT.
V. Personal insight
The main cause of atherosclerosis is damage to the endothelium of the arteries, and the lipid content of the blood enters the endothelium, forming atherosclerosis, which is a complex process and usually occurs only after years and years. From the perspective of prevention, ensuring that blood lipids are as normal as possible, a low-salt, low-fat diet and proper exercise can prevent atherosclerosis. High blood pressure and diabetes are the main factors leading to endothelial damage, so it is also very important to control blood pressure and blood sugar in normal range in general.