非药物干预对短暂性脑缺血发作患者血脂水平及颈动脉粥样硬化斑块的影响研究

Impacts of Non-pharmacological Intervention on the Lipid Levels and Carotid Atherosclerosis in Patients with Transient Ischemic Attack

目的探讨非药物干预对短暂性脑缺血发作(TIA)患者血脂水平及颈动脉粥样硬化斑块的影响。方法选取2009年5月—2011年2月在我院神经内科住院的150例伴颈动脉粥样硬化斑块及血脂异常的TIA患者,随机分为观察组(75例)和对照组(75例),研究中途退出22例,观察组67例,对照组61例。两组患者均口服阿司匹林、营养脑神经细胞及改善脑循环药物。观察组在此基础上采取非药物干预措施(健康宣教、运动处方、饮食指导),对照组给予辛伐他汀药物治疗,两组疗程均为6个月。对两组患者分别在治疗前及治疗6个月后进行血脂检测和颈动脉超声检查。结果观察组治疗前后血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白(HDL)及三酰甘油(TG)水平分别与对照组比较,差异均无统计学意义(t值分别为0.34、1.33、1.34、1.06、0.25、1.07、1.41、1.57,P>0.05)。观察组治疗前后颈动脉斑块面积分别与对照组比较,差异均无统计学意义(t值分别为0.66、0.93,P>0.05)。结论非药物干预具有调脂及抗动脉粥样硬化的作用,可缩小TIA患者的颈动脉粥样硬化斑块,其治疗效果与他汀类药物相似。

Objective To explore the influences of non-pharmaceutical interventions on lipid levels and carotid atherosclerosis in patients with transient ischemic attack（TIA）.Methods Totally 150 TIA inpatients with carotid atherosclerosis and abnormalities of plasma lipids in the department of neurology in our hospital from May 2009 to February 2011 were equally and randomly divided into the study group and the control group.All patients were administrated with aspirin as well as medicines that have effects of neurotrophy and may improve blood circulation.In addition to the medicine,subjects in the study group took non-pharmaceutical interventions at the same time（health education,exercise prescription,and diet guidance）,while subjects in the control group took simvastatin for 6 months.Blood lipids were measured at the baseline and after treatment.The areas of carotid atherosclerosis were detected before and after treatment.Results The serum total cholesterol（TC）,low-density lipoprotein cholesterol（LDL-C）,high-density lipoprotein（HDL）and triglycerides（TG）in the study group showed no significant difference with those in the control group before and after treatment（the t values were 0.34,1.33,1.34,1.06,0.25,1.07,1.41,and 1.57,P0.05）.The areas of carotid atherosclerosis were also not significantly different between the two groups（t=0.66,t=0.93,P0.05）.Conclusion Non-pharmacological intervention can decrease plasma lipid levels and reduce carotid atherosclerosis in TIA patients,showing a similar effect as simvastatin.