阿托伐他汀联合依折麦布对缺血性脑卒中患者临床预后及颈动脉斑块的影响

摘要

目的 分析阿托伐他汀联合依折麦布对缺血性脑卒中患者临床预后及颈动脉斑块的影响.方法 回顾性分析381例缺血性脑卒中患者的临床资料,根据是否采取阿托伐他汀联合依折麦布治疗进行分组;对照组183例,单用阿托伐他汀治疗;观察组198例,采取阿托伐他汀联合依折麦布治疗;均连续治疗、观察24个月;对比两组患者治疗前后的血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平、改良RANKIN量表(mRS)、改良Barthel指数评定量表(MBI)评分、颈动脉斑块面积及分型,以缺血性脑卒中复发率、不良反应的观察指标水平.结果 治疗后,两组血清TC、TG、LDL-C、HDL-C水平均较治疗前显著改善(P＜0.05);但观察组血清TC、LDL-C水平改善幅度大于对照组,差异显著(P＜0.05);治疗后,两组mRS评分、MBI评分均较治疗前显著改善(P＜0.05);但观察组mRS评分、MBI评分改善幅度大于对照组,差异显著(P＜0.05);观察组颈动脉斑块面积较治疗前显著缩小(P＜0.05),分型显著改善(P＜0.05);对照组治疗前后的颈动脉斑块面积及分型差异不显著(P＞0.05);观察组缺血性脑卒中复发率显著小于对照组(P＜0.05),两组不良反应发生率差异不显著(P＞0.05).结论 阿托伐他汀联合依折麦布较单用阿托伐他汀治疗更能有效降低缺血性脑卒中患者血脂水平,改善预后,在缩小并稳定颈动脉斑块方面具有显著优势,且安全性较高,值得临床推广采用.%Objective To analyze the effect of different intensity lipid-lowering regimen on clinical prognosis and carotid plaque in patients with ischemic stroke.Methods The clinical data of 381 patients with ischemic stroke were retrospectively analyzed according to whether or not atorvastatin was combined with ezetimibe treatment.183 patients in the control group were treated with atorvastatin alone and 198 patients in the observation group (TC) were treated with combined treatment.triglyceride (TG),low density lipoprotein cholesterol(LDL-C),and LDL-C were significantly higher than those in the control group.High density lipoprotein cholesterol (HDL-C),modified RANKIN (mRS),improved Barthel Index Rating Scale (MBI)score,carotid plaque area and type,ischemic stroke recurrence rate,adverse reactions were all compared between groups.Results After treatment,the levels of serum TC,TG,LDL-C and HDL-C in both groups were significantly improved (P ＜ 0.05),but the TC and LDL-C levels in the observation group were significantly higher than those in the control group (P ＜ 0.05).The mRS score and MBI score of both groups were significantly improved (P ＜ 0.05),but the improvement rate of mRS score and MBI score in the observation group were significantly higher than that in the control group (P ＜ 0.05).The recurrence rate of ischemic stroke in the observation group was significantly lower than that in the control group (P ＜ 0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P ＞ 0.05).Conclusion Atorvastatin combined with ezetimibe is more effective in reducing the level of blood lipid in patients with ischemic stroke and improving the prognosis.It has significant advantages in reducing and stabilizing carotid tplaque with higher safety,worthy of clinical useage.