阿托伐他汀联合阿司匹林治疗急性脑梗死患者的临床研究

目的 探讨阿托伐他汀联合阿司匹林治疗急性脑梗死患者的疗效及其对神经功能缺损、血脂、颈动脉斑块等影响.方法 选择急性脑梗死患者80例,随机分为阿托伐他汀联合阿司匹林治疗组40例.单用阿司匹林对照组40例,比较两组神经功能缺损程度及疗效,血脂、颈部血管超声的变化,并随访6个月,观察有无再发脑梗死.结果 治疗后三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、颈总动脉内径、斑块体积、阻力指数、搏动指数、神经功能缺损评分在治疗组分别为(1.36±0.33)mmol/L、(5.21±0.32)mmol/L、(1.20±0.10)mmol/L、(1.31±0.37)mmol/L、(6.43±0.71)mm、(40.39±8.94)mm3、(0.70±0.06)、(2.12±0.37)、(10.24±3.31)分,低于对照组[(1.77±0.80)mmol/L、(5.80±0.37)mmol/L、(1.43±0.16)mmol/L、(1.57±0.39)mmol/L、(6.67±0.47)mm、(54.26±8.25)mm3、0.82±0.08、2.18±0.54、(14.69±3.23)分],(均P<0.05或0.01);颈动脉内中膜厚度、收缩期峰值速度治疗组分别为(1.66±0.50)mm、(71.34±15.01)an/s,高于对照组[(1.50±0.68)(68.97±18.21)an/s](均P<0.01);治疗组总有效率92.5%,高于对照组75.0%(P<0.05),6个月内未见脑梗死复发.结论 阿托伐他汀联合阿司匹林治疗急性脑梗死有利于神经功能的恢复和改善预后,对缩小颈动脉粥样斑块体积、稳定斑块、降低血脂各项指标有较好的效果,对干预脑梗死的复发起到积极作用,可作为急性脑梗死治疗的联合药物.

Clinical study of atorvastatin combined with aspirin in the treatment of acute cerebral infarction

Objective To explore the effect of atorvastatin combined with aspirin on therapeutic efficacy of acute cerebral infarction, and on the changes in neurologic impairment, blood lipids and carotid plaque, et al. Methods The 80 patients with acute cerebral infarction were randomly divided into the treatment group (n=40) and the control group (n = 40)who took atorvastatin combined with aspirin and aspirin alone respectively. The defect degree of nerve function, curative effect, changes of blood lipids and cervical vascular ultrasound parameters were compared between the two groups, and they were followed up for 6 months to observe the recurrence of cerebral infarction.Results Compared with the control group, the levels of TG, TC, HDL-C and LDL-C, internal diameter of common carotid artery, size of plaque, drag index, pulsatility index and neurological function deficit scale (NFDS) were significantly lower in treatment group [(1.36 ± 0.33) mmol/L vs.(1.77±0.80) mmol/L, (5.21±0.32) mmol/L vs. (5.80±0.37) mmol/L, (1.20±0.10) mmol/L vs. (1.43±0.16) mmol/L, (1.31±0.37) mmol/L vs. (1.57±0.39) mmol/L, (6.43±0.71) mm vs. (6.67±0.47) mm, (40.39±8.94) mm3 vs. (54.26±8.25) mm3, (0.70±0.06) vs. (0.82±0.08), (2.12±0.37) vs. (2.18±0.54), (10.24±3.31) scores vs. (14.69±3.23) scores, all P＜0.05 or ＜0.01]. The intima-media thickness and peak systolic velocity of carotid artery were higher in treatment group than in control group [(1.66±0.50) mm vs. (1.50±0.68) mm, (71.34±15.01)an/s vs. (68.97 ± 18.21 ) an/s, both P＜ 0.01]. The total effective rate was higher in treatment group than in control group (92.5% vs. 75.0%, P＜0.05), and there were no recurrence of cerebral infarction within 6 months. Conclusions Atorvastatin combined with aspirin in treatment of acute cerebral infarction is beneficial to resume neurological function, improve prognosis, decrease the volume of carotid atherosclerotic plaque, stabilize plaque and reduce blood lipids, and it play an positive action in the intervention of cerebral infarction recurrence, and it can be used to treatment acute cerebral infarction as combination therapy.