大剂量阿托伐他汀联合尿激酶治疗急性脑梗死的疗效观察

Observation on Efficacy of High-dose Atorvastatin Combined with Urokinase in Treatment of Acute Cerebral Infarction

目的:探讨大剂量阿托伐他联汀联合尿激酶治疗急性脑梗死的效果和安全性。方法:选取河南省第二人民医院2010年1月—2015年1月收治的急性脑梗死患者120例,按照随机数字表法分为观察组和对照组,每组各60例。对照组患者给予尿激酶静脉滴注后,同时给予阿托伐他汀10 mg/d,治疗2周;观察组患者给予尿激酶静脉滴注后,给予阿托伐他汀40 mg/d,治疗2周。治疗前和治疗1、3、7 d后及2周时分别对2组患者进行神经功能缺损欧洲卒中量表(european stroke scale,ESS)及日常生活活动能力量表(barthel index,BI)评分;治疗后评价患者临床疗效,并对2组患者的安全性和治疗前后的血生化、出凝血时间、血小板计数进行监测。结果:治疗前2组患者ESS、BI评分比较,差异无统计学意义(P>0.05);治疗1、3、7 d和2周后,观察组患者ESS、BI评分均高于对照组,差异有统计学意义(P<0.05)。观察组患者的总有效率为90.00%(54/60),明显高于对照组的68.33%(41/60),差异有统计学意义(P<0.05)。治疗前后2组患者肝功能、出凝血时间、血小板计数均无明显变化,但观察组患者低密度脂蛋白胆固醇水平明显低于对照组,差异有统计学意义(P<0.05)。结论:大剂量阿托伐他汀联合尿激酶溶栓治疗急性脑梗死的临床疗效显著,可有效改善患者神经功能缺损程度和日常生活能力,且无明显不良反应,值得临床推广。

OBJECTIVE：To observe the efficacy and safety of high-dose atorvastatin combined with urokinase in treatment of acute cerebral infarction.METHODS：120 patients with acute cerebral infarction admitted into the Second People＇s Hospital of Henan from Jan.2010 to Jan.2015 were selected to be divided into observation group and control group via the random number table,with 60 cases in each.The control group were treated with urokinase in intravenous infusion combined with 10 mg / d atorvastatin for two weeks;while the observation group received 40 mg / d atorvastatin after treatment of urokinase in intravenous infusion for two weeks.Before and after treatment of 1 d,3 d,7 d,and 2weeks,the degree of neural function defect scale ESS（european stroke scale） and daily life ability index BI（barthel index） score in two group of patients were observed.After treatment,the clinical efficacy were evaluated;and the safety,blood biochemistry,blood coagulation time and platelet count before and after treatment were monitored.RESULTS：There was no significant difference in ESS,BI score between two groups before treatment（P 〉0.05）.After treatment of 1 d,3 d,7 d,and 2 weeks,ESS,BI score of observation group were higher than that of control group,with statistically significant difference（P〈 0.05）.The total effective rate of observation group was 90.00%（54 /60）,higher than that of control group [68.33%（41 /60） ],with statistically significant difference（P 〈0.05）.There was no significant difference in liver function,blood coagulation time and platelet in two group of patients before and after treatment,yet LDL-C levels of observation group decreased significantly compared with control group,with statistically significant difference（P 〈0.05）.CONCLUSIONS：The efficacy of high-dose atorvastatin combined with urokinase in treatment of acute cerebral infarction is significant,which can improve the patients＇ degree of neurologic deficits and daily life ability,without any obvious increase in adverse reactions,It is worthy of clinical promotion and application.