摘要
目的探讨别嘌醇治疗急性缺血脑卒中合并颈动脉斑块的效果。方法选取2017年1~9月我院收治的120例急性缺血性脑卒中合并颈动脉斑块患者作为研究对象,将其随机分为对照组和观察组,每组各60例。对照组患者给予阿托伐他汀联合阿司匹林肠溶片治疗,观察组患者在对照组的基础上给予别嘌醇治疗。比较两组患者治疗前后的颈动脉斑块变化情况及治疗效果。结果两组患者治疗前的斑块性质比较,差异无统计学意义(P>0.05);两组患者治疗后的稳定斑块发生率高于治疗前,差异有统计学意义(P<0.05);观察组患者治疗后的稳定斑块发生率高于对照组,差异有统计学意义(P<0.05)。治疗前,对照组患者的斑块面积[(0.24±0.12)cm2]与观察组[(0.23±0.11)cm2]比较,差异无统计学意义(P>0.05);观察组患者治疗后的斑块面积[(0.17±0.07)cm2]明显小于对照组[(0.21±0.09)cm2],差异有统计学意义(P<0.05)。观察组患者的治疗总有效率明显高于对照组,差异有统计学意义(P<0.05)。观察组患者治疗前的尿酸水平[(528±58)μmol/L]与对照组[(530±60)μmol/L]比较,差异无统计学意义(P>0.05);观察组患者治疗后的尿酸水平为(416±94)μmol/L,明显低于治疗前,且低于对照组的(525±57)μmol/L,差异有统计学意义(P>0.05)。治疗过程中,观察组有2例(3.3%)患者谷氨酸氨基转移酶升高达正常上限值2倍以上,对照组无不良反应发生,两组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。结论别嘌醇治疗急性缺血性脑卒中合并颈动脉斑块,疗效显著,可有效稳定颈动脉斑块,减少斑块面积,值得推广。
Objective To investigate the effect of Allopurinol in the treatment of acute cerebral ischemic stroke complicated with carotid artery plaque. Methods One hundred and twenty patients with acute cerebral ischemic stroke complicated with carotid plaque were enrolled from January to September in 2017. They were randomly divided into the control group and the observation group, with 60 cases in each group. In the control group, Atorvastatin in combination with Aspirin Enteric-coated Tablets was used, while in the observation group, Allopurinol was added on the basis of the control group. The change of carotid plaque before and after treatment and therapeutic effect were compared between two groups. Results There was no significant difference in the property of plaque before treatment between two groups(P〈0.05). The incidence of stable plaques after treatment in two groups was higher than that before treatment,and the difference was statistically significant(P〈0.05). The incidence of stable plaques in the observation group was higher than that in the control group, and the difference was statistically significant(P〈0.05). There was no significant difference in the plaque area before treatment between the control group([0.24 ±0.12] cm2) and the observation group([0.23±0.11] cm2)(P〈0.05). The plaque area in the observation group([0.17±0.07] cm2) after treatment was significantly smaller than that in the control group([0.21±0.09] cm2), and the difference was statistically significant(P〈0.05). The total effective rate of the observation group was significantly higher than that of the control group, and the difference was statistically significant(P〈0.05). There was no significant difference in the level of uric acid before treatment between the observation group([528±58] μmol/L) and the control group([530 ±60] μmol/L)(P〈0.05). The level of uric acid after treatment in the observation group was(416±94) μmol/L, which was significantly lower than that before treatment and was lower than that in the control group of(525±57) μmol/L, with statistically significant difference(P〈0.05). During the treatment, 2 cases(3.3%) in the observation group had an increase in the level of glutamate aminotransferase 2 times more than the normal upper limit. No adverse reactions occurred in the control group. There was no significant difference in the incidence of adverse reactions between the two groups(P〈0.05). Conclusion Allopurinol has a significant effect in the treatment of acute cerebral ischemic stroke complicated with carotid artery plaque. It can effectively stabilize carotid plaque and reduce plaque area, which is worthy of promotion.
作者
蒋军华
JIANG Jun-hua(First Department of Internal Medicine,Chang'an Hospital in Dongguan City,Guangdong Province,Dongguan 523843,China)
出处
《中国当代医药》
2018年第25期130-132,140,共4页
China Modern Medicine
基金
广东省东莞市社会科技发展项目(201750715022356)
关键词
别嘌醇
阿托伐他汀钙
阿司匹林肠溶片
缺血性脑卒中
颈部动脉斑块
Allopurinol
Atorvastatin calcium
Aspirin Enteric-coated Tablets
Cerebral ischemic stroke
Carotid arterial plaque