阿托伐他汀联合阿司匹林治疗急性脑梗死的临床效果分析

Clinical effect of atorvastatin combined with aspirin in the treatment of acute cerebral infarction

目的 探讨阿托伐他汀联合阿司匹林治疗急性脑梗死患者的临床效果。方法 收集７００例急性脑梗死患者，采用随机数字表法分为两组，每组３５０例，对照组予以阿司匹林治疗，观察组患者则加用阿托伐他汀治疗，比较两组患者神经功能缺损评分、日常生活能力评分、总体治疗效果、疾病相关参数与不良反应。结果 观察组治疗后ＮＩＨＳＳ评分、颈动脉内中膜厚度、斑块面积、阻力指数、总胆固醇、甘油三酯、低密度脂蛋白、超敏Ｃ反应蛋白、氧化低密度脂蛋白、丙二醛、肿瘤坏死因子α、白细胞介素６、白细胞介素１β水平分别为（１１．２０±３．８７）分、（１．０４±０．１３）ｍｍ、（０．５１±０．０７）ｃｍ２、（６３．２６±２．５６）％、（４．２１±０．２７）ｍｍｏｌ／Ｌ、（１．３２±０．１２）ｍｍｏｌ／Ｌ、（１．５１±０．２０）ｍｍｏｌ／Ｌ、（１．６１±０．５０）ｍｇ／Ｌ、（４２．５０±７．１５）ｍｇ／Ｌ、（４．３３±１．３４）μｍｏｌ／Ｌ、（４１９６５±５１．１６）μｇ／Ｌ、（１２０．０４±２２．５０）ｎｇ／Ｌ、（３１０．４５±４４．８２）ｎｇ／Ｌ，显著性低于对照组的（１４．７９±３６４）分、（１．２０±０１７）ｍｍ、（０．６７±０．１２）ｃｍ２、（６５．３８±２．７０）％、（４．７６±０．３６）ｍｍｏｌ／Ｌ、（１．７５±０．１７）ｍｍｏｌ／Ｌ、（１．９２±０．２７）ｍｍｏｌ／Ｌ、（２．３２±０．６７）ｍｇ／Ｌ、（６０．１５±９．１５）ｍｇ／Ｌ、（６．１９±１．４０）μｍｏｌ／Ｌ、（４８０６２±５５．９６）μｇ／Ｌ、（１５７．３３±２５．７９）ｎｇ／Ｌ、（３５７．３９±４６．２０）ｎｇ／Ｌ；Ｂａｒｔｈｅｌ指数、颈动脉管腔直径、收缩期峰值血流速度、舒张期峰值血流速度、高密度脂蛋白胆固醇与超氧化物歧化酶水平分别为（７５．４０±７．９６）、（７５７±０．２４）ｍｍ、（０．７８９±０１８２）ｍ／ｓ、（０．３１４±０．０３０）ｍ／ｓ、（１．６９±０．１５）ｍｍｏｌ／Ｌ、（１２２．６４±１９．５５）U/mL显著高于对照组的（６７．２７±７．５５）、（７．２３±０．２８）ｍｍ、（０．６７３±０．１２５）ｍ／ｓ、（０．２２６±０．０２９）ｍ／ｓ、（１．４２±０２０）ｍｍｏｌ／Ｌ、（１０３．６０±１６６８）Ｕ／ｍＬ；显效率与总有效率５６％、０．５７％，均显著性高于对照组的３９．７１％、６８．００％（χ２＝１８．５９９、１４４７８，均Ｐ＜０．０１）。结论 阿托伐他汀联合阿司匹林治疗急性脑梗死患者的临床效果显著，安全性较高。

Objective To investigate the clinical effect of atorvastatin combined with aspirin in the treatment of acute cerebral infarction （ACI）. Methods 700 patients with ACI were selected, and they were randomly divided into two groups according to the digital table, with 350cases in each group. The control group was treated with aspirin. The observation group was given atorvastatin combined with aspirin. The neurological deficits, daily living ability, overall treatment effect, disease related parameters and adverse reactions were compared between the two groups. Results After treatment,the NIHSS score,carotid IMT,plaque area,RI,TC,TG,LDL - C,hs - CRP,oxLDL,MDA,TNF - α, IL -6 and IL - 1 levels in the observation group were （ 11.20 ± 3.87） points, （ 1.04 ± 0. 13） mm, （0. 51 ± 0.07）cm2,（63.26 ±2.56）% ,（4.21 ±0.27）mmol/L, （1.32 ±0. 12） retool/L, （1.51 ± 0.20） retool/L, （1.61 ± 0. 50） rag/L, （42.50 ± 7.15 ） mg/L, （ 4.33 ± 1.34 ） μmol/L, （ 419.65 ± 51.16 ） μg/L, （ 120.04 ± 22.50 ） ng/L, （310.45 ±44.82）ng/L, respectively, which were significantly lower than those in the control group [ （14.79 ± 3.64）points, （1.20 ±0. 17） mm, （0.67 ± 0. 12） cm2, （65.38 ± 2.70）%, （4.76 ± 0. 36） mmol/L, （ 1.75 ± 0. 17 ） mmol/L, （ 1.92 ± 0.27 ） mmol/L, （ 2.32 ± 0.67 ） mg/L, （ 60. 15 ± 9.15 ） mg/L, （ 6.19 ± 1.40 ） μmol/L, （480. 62 ± 55.96） μg/L, （ 157.33 ± 25.79 ） ng/L, （ 357.39 ± 46.20 ） ng/L ]. The Barthel index, carotid artery lumen diameter,SV, DV, HDL- C and SOD levels in the observation group were （75.40 ± 7.96 ）, （7.57 ± 0. 24）mm, （0.789 ±0. 182） m/s, （0. 314 ± 0. 030） m/s, （ 1.69 ± 0. 15 ） mmol/L, （ 122. 64 ± 19. 55 ） U/mL, respectively, which were significantly higher than those in the control group [ （67.27 ± 7.55 ）, （7.23 ± 0.28 ） mm, （0. 673 ± 0. 125 ） m/s, （0. 226 ±0.029）m/s,（1.42 ±0.20）mmol/L,（103.60 ± 16.68）U/mL]. The obvious effective rate and total effective rate of the observation group were 56.00% and 80.57%, respectively,which were significantly higher than those of the control group （39.71% and 68.00% ,X2 =18.599,14,478,all P 〈0.01）. Conclusion Atorvastatin combined with aspirin in the treatment of patients with ACI has significant clinical effect and high safety.