阿托伐他汀钙联合阿司匹林治疗急性脑梗死的疗效观察

Observation of the efficacy of atorvastatin combined with aspirin in the treatment of acute cerebral infarction

目的探讨阿托伐他汀钙联合阿司匹林治疗急性脑梗死的疗效观察。方法选择160例急性脑梗死患者，按照数字表法随机分为观察组与对照组，各80例。对照组使用阿司匹林治疗，观察组在对照组基础上联合阿托伐他汀钙治疗，两组患者均随访1年，比较两组患者日常生活能力量表评分、美国国立卫生院神经功能缺损评分（NIHSS评分）、CRP、TNF-仪水平、颈动脉内膜中层厚度（IMT）。结果观察组治疗后6个月、治疗后12个月Barthel指数分别为（75．15±6．67）、（79．94±7．84），均明显高于对照组的（61．64±7．35）、（65．24±6．67），差异有统计学意义（t=6．214，P=0．005；t=6．514，P=0．001）；观察组治疗后6个月、治疗后12个月NIHSS评分分别为（3．55±0．85）分、（2．07±0．35）分，均明显低于对照组的（5．79±0．68）分、（4．44±0．79）分，对比差异有统计学意义（t=5．765，P=0．008；t=5．876，P=0．006）；观察组和对照组治疗后CRP、TNF—α、IMT相比治疗前均有明显改善，组间对比差异有统计学意义（观察组：t=18．732，P=0．000：t=15．652，P=0．000；t=3．593，P=0．000；对照组：t=7．324，P=0．000；t=4．211，P=0．000；t=2．495，P：0．035）；观察组CRP、TNF—α、IMT改善优于对照组，对比差异有统计学意义（t=8．893，P=0．000；t=5．819，P=0．000；t=2．984，P=0．015）。结论阿托伐他汀钙联合阿司匹林治疗急性脑梗死利于改善患者日常生活能力及神经功能，并有效控制CRP、TNF-α、IMT。

Objective To investigate the clinical efficacy of atorvastatin combined with aspirin in the treatment of acute cerebral infarction. Methods 160 patients with acute cerebral infarction were selected, they were randomly divided into two groups ,80 cases in each group. The patients in both two groups used aspirin for treatment, while the observation group used atorvastatin for further treatment. All patients were followed up for 1 year, and the ADL score, the US National Institutes of Health neurological function （NIHSS） score, C -reactive protein （CRP）, tumor necrosis factorct （ TNF -α） and carotid intima - media thickness （IMT） were compared between the two groups. Results Six months and 12 months later after the treatment, the Barthel index in the observation group [ （75.15 ± 6.67 ）points and （79.94 ±7. 84） points]were higher than those in the control group E （ 5. 79 ±0. 68） points and （4.44 ± 0.79 ） points ], the differences were statistically significant （ t = 6.214, P = 0.005 ; t = 6.514, P = 0.001 ）. Six months and 12 months later after the treatment, the NIHSS scores in the observation group [ （3.55 ±0. 85 ） points and （2.07 ± 0.35 ） points ] were higher than those in the control group [ （ 5.79± 0.68 ） points and （ 4.44 ±0. 79 ） points ], the differences were statistically significant（ t = 6. 214, P = 0. 005;t = 6. 514,P = 0. 001 ）. The levels of CRP, TNF - α and IMT of the observation group and the control group after treatment decreased significantly（ the observation group： t = 18. 732 ,P = 0. 000 ; t = 15. 652, P = 0. 000 ; t = 3. 593, P = 0. 000 ; the control group ： t = 7. 324, P = O. 000 ; t = 4. 211 ,P = 0.000 ; t = 2. 495, P = 0. 035 ）. Moreover, the levels of CRP, TNF - α and IMT of the observation group were lower than those of the control group （ t = 8. 893, P = 0. 000 ; t = 5. 819, P = 0. 000 ; t = 2. 984, P = 0. 015 ）. Conclusion Atorvastatin combined with aspirin therapy can improve the daily skills and nerve function in patients with acute cerebral infarction. Moreover, it is effective to decrease the levels of CRP,TNF-α, IMT.