纤溶酶与阿托伐他汀联合治疗短暂性脑缺血发作的临床研究

摘要

目的:探讨纤溶酶(Plm)联合阿托伐他汀(ATV)治疗短暂性脑缺血发作(TIA)的临床效果及对患者血液流变学和血清基质金属蛋白酶(MMP)-9、超敏C-反应蛋白(hs-CRP)水平的影响.方法:选取2015年2月至2017年2月100例TIA患者,采用随机数字表法均分为两组.对照组(50例)予以ATV治疗,观察组(50例)在此基础上加用Plm治疗.记录比较两组临床疗效,治疗前后血液流变学状态及血清MMP-9、hs-CRP 水平变化,不良反应发生情况.结果:治疗4周后,观察组总有效率达94. 0%,较对照组明显升高(74.0%,P<0.05).与治疗前比较,两组治疗4周后全血高切黏度(HBV)、全血低切黏度(LBV)、血浆黏度(SV)、红细胞积压(HCT)值均显著降低(P<0.01),且观察组以上血液流变学指标下降较对照组更显著(P<0.01).两组治疗4周后血清MMP-9、hs-CRP 水平较治疗前均显著下降(P<0.01);且观察组降低更显著(P<0.01).与对照组(10.0%)相比,观察组不良反应率为6.0%,差异无统计学意义(P>0.05).结论:纤溶酶联合阿托伐他汀治疗短暂性脑缺血发作更能有效缓解患者症状体征,显著改善其机体血液流变学和微循环状态,疗效更佳且安全可靠.%Objective:To investigate the clinical efficacy of plasmin (Plm) combined with atorvastatin (ATV) on transient ischemic attack (TIA) and its impact on the hemorheology and serum matrix metallopro-teinase - 9 (MMP-9),hypersensitivity C-reactive protein(hs-CRP) levels in patients. Methods:100 ca-ses of TIA in our hospital from February 2015 to February 2017 were selected and divided into two groups by random number table. The control group(50 cases) was treated with ATV,and the observation group(50 ca-ses) was additionally treated with Plm. The clinical efficacy,the changes of Hemorheology and serum MMP-9 and hs-CRP levels and the incidence of adverse reactions before and after treatment were recorded and com-pared between the two groups. Results:After 4 weeks of treatment, the total effective rate of the observation group was 94%,which was significantly higher than that of the control group(74%,P<0.05).Compared with before treatment,the values of high shear viscosity (HBV),whole blood low shear viscosity (LBV),plasma viscosity (SV) and red cell backlog (HCT) were significantly decreased in the two groups after 4 weeks of treatment (P<0.01),and the blood rheology indexes above the observation group were significantly lower than those of the control group(P<0.01). After two weeks of treatment,the serum levels of MMP-9 and hs-CRP were significantly decreased (P<0.01) in the 4 groups, and the decrease in the observation group was more significant (P<0.01). Compared with the control group (10%), the adverse reaction rate in the observation group was 6%,the difference was not statistically significant (P>0.05). Conclusion:The combination of fi-brinolytic enzyme and atorvastatin in the treatment of transient ischemic attack can effectively relieve the symp-toms and signs of the patients,improve the blood rheology and microcirculation of the body significantly,and the curative effect is better and safe and reliable.