阿托伐他汀片联合血塞通注射液对脑梗死患者血脂及血液流变学的影响

Influence of Atorvastatin Tablets plus Xuesaitong Injection on Blood Lipids and Hemorheology in Cerebral Infarction Patients

目的 探讨阿托伐他汀联合血塞通注射液对脑梗死患者血脂及血液流变学的影响。方法选取2013年9月至2014年9月广州中医药大学附属重庆北碚中医院诊治的急性脑梗死患者90例,按照随机数字表法分为观察组和对照组,各45例。对照组患者采用静脉滴注血塞通注射液,每次注射200~400 m L,每日注射1次,1周为1疗程,连续注射2周。观察组患者采用阿托伐他汀联合血塞通注射液治疗,每日1次,每次20 mg,1周为1个疗程,连续服用2周。观察患者治疗后血脂指标以及血液流变学变化情况以及治疗后的临床疗效和病情复发率。结果 治疗后两组总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）均较治疗前显著降低,高密度脂蛋白胆固醇（HDL-C）均较治疗前显著升高,观察组TC、TG、LDL-C显著低于对照组[（4.32±0.98）mmol/L比（5.87±0.78）mmol/L,（2.65±0.31）mmol/L比（3.23±0.98）mmol/L,（2.45±0.99）mmol/L比（2.89±1.07）mmol/L],HDL-C显著高于对照组[（2.42±0.29）mmol/L比（2.09±0.45）mmol/L],差异有统计学意义（P〈0.05）。治疗后两组全血高切黏度、全血低切黏度以及血浆黏度均较治疗前显著降低,观察组全血高切黏度、全血低切黏度以及血浆黏度显著低于对照组[（4.98±1.09）m Pa·s比（5.61±1.42）m Pa·s,（8.72±2.65）m Pa·s比（11.32±3.18）m Pa·s、（1.32±0.21）m Pa·s比（1.48±0.29）m Pa·s],差异有统计学意义（P〈0.05）。观察组治疗后有效率显著高于对照组[93.33%（42/45）比77.78%（35/45）],差异有统计学意义（P〈0.05）。观察组病情复发率低于对照组[2.22%（1/45）比13.33%（6/45）],差异有统计学意义（P〈0.05）。结论 阿托他汀联合血塞通注射液对治疗脑梗死患者取得的临床疗效显著,明显降低患者的血脂,对改善脑梗死疾病有显著效果,值得临床推广使用。

Objective To study the effects of atorvastatin tablets plus Xuesaitong injection on blood lipids and hemorheology in cerebral infarction patients. Methods Total of 90 acute cerebral infarction patients admitted to Chongqing Beibei Hospital Affiliated to Guangzhou University of Chinese Medicine from Sep. 2013 to Sep. 2014 were included in the study,according to a random number table they were divided into an observation group and a control group ,45 patients each. The control group was treated with intravenous Xue- setong injection,200-400 mL per time, once a day, 1 week as a treatment course, continuously for 2 weeks. The observation group was treated with atorvastatin joint Xuesetong injection therapy, once a day, 20 mg per time, 1 week as a course, aministered for 2 weeks continuously. After treatment, patients＇ lipid levels, hemorheologychanges,clinical efficacy, and relapse rate situation were observed. Results The total cholesterol （ TC）, triglyceride （ TG ）, low density lipoprotein cholesterol （ LDL-C ） of both groups were significantly decreased from before treatment, high density lipoprotein cholesterol （HDL-C） was significantly increased than before treatment,TC ,TG, LDL-C of the observation group were significantly lower than the control group [ （4.32 ±0.98） mmol/L vs （5.87 ±0. 78） mmol/L, （2.65 ±0. 31 ） mmol/L vs （3.23 ±0.98） mmol/L, （2.45 ±0. 99） mmol/L vs （2. 89 ±1.07） mmol/L], HDL-C was significantly higher than the control group [ （2. 42±0. 29） mmol/L vs （2. 09 ±0. 45 ） mmoI/L], the differences were statistically significant （ P 〈 0. 05）. The whole blood high shear viscosity, whole blood low shear viscosity and plasma viscosity of both groups after treatment were decreased significantly from before the treatment, and the observation group＇s indexes were significantly lower than the control group＇s [ （4. 98 ± 1.09） mPa · s vs （5.61 ± 1.42） mPa · s, （8.72 ±2. 65） mPa · s vs （11.32 ±3.18） mPa ·s,（1.32 s0.21） mPa · s vs （1.48 s0.29） mPa · s], the differences were statistically significant （ P 〈 0.05 ）. The clinical efficacy of the observation group was higher than the control group [ 93.33 % （42/45） vs 77.78% （35/45） ], with statistically significant difference （P 〈 0. 05 ）. The recurrence rate of the observation group was lower than the control group [ 2.22 % （ 1/ 40） vs 13.33% （6/40） ], with statistically significant difference（P 〈0. 05）. Conclusion Atorvastatin plus Xuesetong injection has sgnificant clinical efficacy for patients with cerebral infarction, which can significantly decrease the blood lipids and improve cerebral diseases, thus is worthy of the clinical use.