经颅超声溶栓联合阿托伐他汀钙治疗动脉粥样硬化性脑梗死的临床疗效

Clinical Effects of Transcranial Sonothrombolysis Combined with Atorvastatin Treatment of Atherosclerotic Cerebral Infarction Patients

目的探讨经颅超声溶栓联合阿托伐他汀钙治疗动脉硬化性脑梗死的效果。方法选择2014年1月至2015年1月芜湖市第二人民医院收治的62例急性脑梗死患者为研究对象,采用随机数字法将患者分为联合治疗组和他汀治疗组,每组31例。他汀治疗组在常规治疗的基础上给予阿托伐他汀治疗(每日20 mg,每日1次,口服),联合治疗组在他汀治疗组的基础上联合经颅超声溶栓治疗(每日2次,每次20 min,治疗7 d)。比较两组患者治疗后的血脂[总胆固醇、低密度脂蛋白胆固醇(LDL-C)、三酰甘油、高密度脂蛋白胆固醇(HDL-C)]水平、颈动脉斑块指标[颈动脉内中膜厚度(IMT)、颈动脉斑块面积]、神经功能缺损[美国国立卫生研究院卒中量表(NIHSS)]及日常生活活动能力(Barthel指数)的改善情况。结果治疗后,两组患者的总胆固醇、LDL-C、三酰甘油、IMT、颈动脉斑块面积、NIHSS均低于治疗前(P<0.05),且联合治疗组较他汀治疗组更低[(2.81±0.27)mmol/L比(3.61±0.39)mmol/L、(1.35±0.21)mmol/L比(1.91±0.25)mmol/L、(0.61±0.09)mmol/L比(1.01±0.10)mmol/L、(1.0±0.3)mm比(1.3±0.5)mm、(16.1±6.3)mm^3比(23.7±6.5)mm^3、(7.6±1.7)分比(10.2±1.6)分](P<0.05);治疗后,两组患者HDL-C水平以及Barthel指数均高于治疗前,且联合治疗组较他汀治疗组Barthel指数更高[(78±6)分比(51±5)分](P<0.05)。结论经颅超声溶栓联合阿托伐他汀钙治疗动脉硬化性脑梗死的效果显著,其能显著降低患者血脂水平、缩小颈动脉斑块面积,改善神经功能缺损情况、提高患者生活活动能力。

Objective To investigate the clinical effects of sonothrombolysis combined with atorvastatin treatment of atherosclerotic cerebral infarction patients. Methods A total of 62 patients with acute cerebral infarction in Wuhu Second People＇s Hospital from Jan. 2014 to Jan. 2015 were included in the study. The patients were divided into a combination therapy group and an atorvastatin therapy group according to the random number method,31 patients in each group. The atorvastatin therapy group was also given atorvastatiu（20 mg per time,one time per day,oral） on the basis of the routine treatment, and combination therapy group was given transcranial sonothrombolysis treatment （twice a day, 20 min every time, for 7 days ） on the basis of atorvastatin therapy group. The blood lipid levels [ serum total cholesterol （ TC）, low density lipoprotein choles-terol （ LDL-C）, triglycerides （ TG）, high density lipoprotein cholesterol （ HDL-C ） ], carotid plaque indexes [ intima- media thickness（IMT） ,carotid plaque area] ,nerve function defect[ national institute of health stroke scale（NIHSS） and daily living ability （Bartbel index scores） ] were compared between the two groups after treatment. Results The TC,LDL-C,TG, I MT, carotid plaque area and NIHSS levels of the two groups after treatment were＇lower than before treatment （P 〈 0. 05 ）, and the combination therapy group was lower than those in the atorvastatin therapy group[ （2. 81 ±0. 27） mmol/L vs （3.61 ± 0. 39） mmol/L, （ 1.35 ±0. 21 ） mmol/L vs （ 1.91 ±0. 25） retool/L, （0. 61 ±0. 09） mmol./L vs （ 1. 01 ±0. 10） mmol/L, （1.0±0.3） mm vs （1.3 ±0.5） mm,（16. 1 ±6.3） mm3 vs （23.7 ±6.5） mm3,（7.6 ±1.7） score vs （10.2 ±1.6） score] （P 〈 0.05）. Both of HDL-C and Barthel index scores of the two groups after treatment were higher than before treatment, and the combination therapy group was higher than the atorvastatin therapy group [ （ 78 ± 6 ） vs （ 51 ± 5 ） ] （ P 〈 0. 05）. Conclusion The effect of transcranial sonothrombolysis combined with atorvastatin for treatment of brain atherosclerotic infarct is good, which can significantly lower the blood lipid levels, reduce carotid palaque area, improve neurologic impairment and enhance the living ability of the patients.