阿托伐他汀联合荷丹片治疗急性脑梗死的临床疗效

摘要

目的 观察阿托伐他汀联合荷丹片治疗急性脑梗死的临床疗效.方法 选取十堰市妇幼保健院2015年11月—2017年7月收治的急性脑梗死患者100例,采用随机数字表法分为单独治疗组和联合治疗组,每组50例.在常规治疗基础上,单独治疗组患者给予阿托伐他汀治疗,联合治疗组患者在单独治疗组基础上加用荷丹片治疗;两组患者均连续治疗6个月.比较两组患者临床疗效,治疗前后血脂指标〔低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、三酰甘油(TG)〕、实验室检查指标〔肌酸激酶(CK)、肌酐(Cr)、尿素氮(BUN)、丙氨酸氨基转移酶(ALT)、和肽素、N末端B型利钠肽前体(NT-proBNP)、E选择素、细胞间黏附分子1(ICAM-1)、血管性假血友病因子(vWF)〕、改良Barthel指数(MBI)评分及美国国立卫生研究院卒中量表(NIHSS)评分,并观察两组患者治疗期间不良反应发生情况.结果 联合治疗组患者临床疗效优于单独治疗组(P<0.05).治疗前两组患者血清LDL-C、HDL-C、TC、TG水平比较,差异无统计学意义(P>0.05);治疗后联合治疗组患者血清LDL-C、TC、TG水平低于单独治疗组(P<0.05),而两组患者血清HDL-C水平比较,差异无统计学意义(P>0.05).治疗前两组患者血清CK、Cr、BUN、ALT、和肽素、NT-proBNP、E选择素、ICAM-1、vWF水平比较,差异无统计学意义(P>0.05);治疗后联合治疗组患者血清ALT水平高于单独治疗组,血清和肽素、NT-proBNP、E选择素、ICAM-1、vWF水平低于单独治疗组(P<0.05),而两组患者血清CK、Cr、BUN水平比较,差异无统计学意义(P>0.05).治疗前两组患者MBI评分、NIHSS评分比较,差异无统计学意义(P>0.05);治疗后联合治疗组患者MBI评分高于单独治疗组,NIHSS评分低于单独治疗组(P<0.05).治疗期间联合治疗组患者不良反应发生率低于单独治疗组(P<0.05).结论 阿托伐他汀联合荷丹片治疗急性脑梗死的临床疗效确切,可有效改善患者血脂代谢、神经功能及预后,有利于减轻炎性反应,减少不良反应的发生.%Objective To observe the clinical effect of atorvastatin combined with Hedan tablets on acute cerebral infarction. Methods A total of 100 patients with acute cerebral infarction were selected in Maternal and Child Health Care Hospital of Shiyan from November 2015 to July 2017, and they were divided into A group and B group according to random number table, each of 50 cases. Based on conventional treatment, patients in A group received atorvastatin, while patients in B group received atorvastatin combined with Hedan tablets; both groups continuously treated for 6 months. Clinical effect, blood lipids index ( including LDL-C, HDL-C, TC and TG), laboratory examination results ( including CK, Cr, BUN, ALT, Copeptin, NT-proBNP, E-selectin, ICAM-1 and vWF), MBI score and NIHSS score before and after treatment were compared between the two groups, and incidence of adverse reactions was observed during treatment. Results Clinical effect in B group was statistically significantly better than that in A group ( P<0.05). No statistically significant differences of serum level of LDL-C, HDL-C, TC or TG was found between the two groups before treatment, nor was serum HDL-C level after treatment ( P>0.05), while serum levels of LDL-C, TC and TG in B group were statistically significantly lower than those in A group after treatment ( P<0.05).No statistically significant differences of serum level of CK, Cr, BUN, ALT, Copeptin, NT-proBNP、E-selectin, ICAM-1 or vWF was found between the two groups before treatment, nor was serum level of CK, Cr or BUN after treatment ( P>0.05); after treatment, serum ALT level in B group was statistically significantly higher than that in A group, while serum levels of Copeptin, NT-proBNP, E-selectin, ICAM-1 and vWF in B group were statistically significantly lower than those in A group ( P>0.05). No statistically significant differences of MBI score or NIHSS score was found between the two groups before treatment ( P>0.05);after treatment, MBI score in B group was statistically significantly higher than that in control group, while NIHSS score in B group was statistically significantly lower than that in A group ( P<0.05). Incidence of adverse reactions in B group was statistically significantly lower than that in A group during treatment ( P<0.05). Conclusion Atorvastatin combined with Hedan tablets has certain clinical effect in treating patients with acute cerebral infarction, can effectively adjust the blood lipid metabolism, improve the neurological function and prognosis, is helpful to relieve the inflammatory reaction and reduce the risk of adverse reactions.