不同剂量纤溶酶联合他汀类药物治疗颈动脉硬化斑块临床效果分析

摘要

目的 分析不同剂量纤溶酶联合他汀类药物治疗颈动脉硬化斑块的临床效果.方法 选取2014年1月至2016年1月解放军第二六六医院收治的颈动脉硬化并斑块形成患者171例.按照随机数字表法分为对照组(52例)、纤溶酶100 U组(59例)和纤溶酶200 U组(60例),对照组服用阿司匹林肠溶片(0.1g/次、1/d)及阿托伐他汀钙(20 mg/次、1/d).纤溶酶100 U组、纤溶酶200 U组在对照组基础上分别给予纤溶酶100、200 U,1次/d静脉滴注,连续用药10 d.治疗后6个月进行疗效评估,统计并比较3组患者的有效率、治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、颈动脉内膜中层厚度及Crouse总积分差值.结果 治疗后,患者颈动脉硬化斑块均有改善.纤溶酶100 U组、纤溶酶200 U组有效率分别为81.4％ (48/59)、85.0％ (51/60),明显高于对照组的64.7％ (33/51);且纤溶酶200 U组高于纤溶酶100 U组,差异均有统计学意义(均P＜0.05).纤溶酶200 U组治疗后NIHSS评分和颈动脉内膜中层厚度低于纤溶酶100 U组,差异有统计学意义[(1.4±1.3)分比(2.3±1.4)分、(2.2±1.0) mm比(2.5±1.2)mm](P＜0.05).治疗前后对照组、纤溶酶100 U组、纤溶酶200 U组的Crouse总积分差值分别为1.08、0.97、1.42,纤溶酶200 U组优于对照组和纤溶酶100 U组,差异有统计学意义(P＜0.05).结论 纤溶酶联合阿司匹林和他汀类药物治疗颈动脉硬化斑块临床疗效确切,且与纤溶酶剂量相关.%Objective To analyze the clinical effect of different doses of fibrinolysin with statins on carotid atherosclerotic plaques.Methods A total of 171 patients with carotid atherosclerotic plaques from January 2014 to January 2016 in No.266 Hospital of Chinese People's Liberation Army were randomly divided into control group (52 cases),fibrinolysin 100 U group(59 cases) and fibrinolysin 200 U group(60 cases).The control group was treated with aspirin enteric coated tablet 0.1 g/time,1 time/d and atorvastatin calcium 20 mg/time,1 time/d.The fibrinolysin 100 U group and fibrinolysin 200 U group were added fibrinolysin 100 U and 200 U respectively,with 1 time/d intravenous drop infusion for 10 d.At 6 months after treatment,clinical effective rate,the National Institute of Health stroke scale(NIHSS) score,carotid artery intima-media thickness and Crouse score were analyzed.Results Effective rates in fibrinolysin 100 U group and fibrinolysin 200 U group were higher than that in control group[81.4％ (48/59),85.0％ (51/60) vs 64.7％ (33/51)],and the effective rate in fibrinolysin 200 U group was higher than that in fibrinolysin 100 U group,the differences were statistically significant(P ＜ 0.05).The NIHSS score and carotid artery intima-media thickness in fibrinolysin 200 U group were significantly lower than those in fibrinolysin 100 U group after treatment [(1.4 ± 1.3) scores vs (2.3 ± 1.4) scores,(2.2 ± 1.0) mm vs (2.5 ± 1.2) mm] (P ＜ 0.05).The difference values of Crouse score before and after treatment in control group,fibrinolysin 100 U group and fibrinolysin 200 U group were 1.08,0.97 and 1.42,respectively;there was statistically significant difference between fibrinolysin 100 U group and fibrinolysin 200 U group (P ＜ 0.05).Conclusion The efficacy data of fibrinolysin with statins in treating carotid atherosclerotic plaques is encouraging,the curative effect is associated with the dose of fibrinolysin.