氯吡格雷联合阿托伐他汀钙治疗急性脑梗死疗效观察

目的:对比氯吡格雷联合阿托伐他汀钙与单用阿托伐他汀钙治疗脑梗死的疗效。方法:将符合入选标准的110例患者随机分为观察组和对照组各55例,观察组在常规治疗的基础上加用氯吡格雷和阿托伐他汀钙,对照组单用阿托伐他汀钙,分别于治疗前、治疗后3个月检测患者的血脂水平、颈动脉中膜厚度(IMT);对患者进行0.5年随访,用美国国立卫生研究所脑卒中量表(NIHSS)和日常生活功能量表(ADL)进行评分,评定患者神经功能缺损和日常生活能力。结果:治疗后3个月与治疗前比较,观察组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)均下降(P<0.05),对照组TC值、LDL-C值下降(P<0.05);观察组患者经治疗后3个月IMT值较治疗前降低(P<0.05);治疗后6个月两组患者ADL评分增加、NIHSS评分减低,但是治疗后6个月时观察组ADL评分高于对照组(P<0.05),NIHSS评分低于对照组(P<0.05)。结论:氯吡格雷联用阿托伐他汀钙应用于脑梗死患者能更有效地降脂、使IMT变薄、有效改善脑梗死患者日常生活活动能力和神经功能缺损。

Curative Effect of Clopidogrel Combined with Atorvastatin Calcium in the Treatment of Patients with Acute Cerebral Infarction

Objective： To contrast the curative effect of clopidogrel combined with atorvastatin calcium with that of atorvas- tatin calcium only in patients with acute cerebral infarction. Methods： 110 cases of acute cerebral infarction were randomly di- vided into the treatment group （55 cases） and the control group （55 cases）. The treatment group was given clopidogrel and ator- vastatin calcium on the basis of conventional treatment and the control group was given clopidogrel only. Blood lipid level and ca- rotid intima- media thickness （IMT） of the patients from both the groups were assayed, respectively, three months before and after the treatment. A six - month follow - up was made to assess the defect of nerve function and the daily living skills of the pa- tients with National Institutes of Health Stroke Scale （NIHSS） and the activities of daily living Scale （ADL）. Results： The indi- ces of Total cholesterol （ TC）, triglyceride （TG） and lower ddensity lipoprotein - cholesterol （ LCD - C） all decreased three months after treatment in the treatment group （ P 〈 0.05 ） ; the indices of TC and lipoprotein - cholesterol （ LCD - C） decreased three months after the treatment in the control group （ P 〈 0.05 ） ; the indices of IMT decreased three months after the treatment in the treatment group （ P 〈 0.05 ）. The scores of ADL of the patients from both the groups were increased six months after the treatment, with the ADL score higher in the treatment group than that in the control group （ P 〈 0.05 ）, while the scores of NIHSS of the patients from both the groups were decreased six months after the treatment, with NtHSS score lower in the treatment group than that in the control group （ P 〈 0.05）. Conclusion： Clopidogrel combined with atorvastatin calcium therapy can effectively lower the blood lipid level, thin down IMT, improve the daily living ability and restore the nervous function.