羟乙基淀粉联合阿托伐他汀对分水岭脑梗死患者神经功能缺损及WBV、PV、FIB、CBF、Hcy水平的影响

Effect of hydroxyethyl starch combined with atorvastatin on neurological function damage and levels of WBV,PV,FIB,CBF,Hcy in patients with watershed cerebral infarction

目的探讨羟乙基淀粉联合阿托伐他汀治疗对分水岭脑梗死(CWI)患者神经功能缺损及全血黏度(WBV)、血浆黏度(PV)、纤维蛋白原(FIB)、脑血流量(CBF)、同型半胱氨酸(Hcy)水平的影响。方法 84例CWI患者随机分为观察组与对照组各42例。对照组在常规对症治疗基础上加用阿托伐他汀治疗,观察组在对照组基础上加用羟乙基淀粉治疗。治疗28d后评价临床疗效,治疗前、治疗后2w、3个月后Barthel指数、神经功能缺损评分(NIHSS),并测定WBV、PV、FIB、CBF、Hcy,并检测糖、脂代谢指标(FBG、2hPG、TC、TG、LDL)及血压水平。结果观察组总有效率明显高于对照组(92.86%vs 76.19%);治疗后7d、14d、28d和3个月,观察组的NIHSS评分显著低于对照组(P<0.05);治疗后28d、3个月,观察组的BI指数显著高于对照组(P<0.05);治疗28d后,观察组的WBV、PV、FIB、Hcy、FBG、2hPG、TC、TG、LDL均显著低于对照组,CBF显著高于对照组(P<0.05),两组DBP、SBP比较差异无统计学意义(P>0.05)。结论羟乙基淀粉联合阿托伐他汀治疗CWI能够降低患者的WBV、PV、FIB和Hcy,并增加CBF,从而改善患者的神经功能缺损,具有临床推广应用价值。

Objective To investigate the effect of hydroxyethyl starch combined with atorvastatin on neurological function damage and levels of whole blood viscosity(WBV),plasma viscosity(PV),fibrinogen(FIB),cerebral blood flow(CBF)and homocysteine(Hcy)in patients with watershed cerebral infarction(CWI).Method 84 patients with CWI were enrolled and randomly divided into observation group and control group,42 cases in each group.The patients in the control group were administered with atorvastatin on the basis of symptomatic treatment,the patients in observation group were administered with hydroxyethyl starch on the basis of control group.28days after treatment,the efficacy was evaluated,the Barthel index and National Institutes of Health Stroke Scale(NIHSS)score between the two groups were evaluated,the levels of WBV,PV,FIB,CBF and Hcy,the indexes of glucose and lipid metabolism(FBG,2hPG,TC,TG and LDL)and blood pressure were detected.Results The total effective rate of the observation group was significantly higher than that of the control group(92.86%vs 76.19%,P<0.05);At 7days,14days,28days and 3 months after treatment,the NIHSS score of the observation group was significantly lower than that of the control group(P<0.05);At 28days and 3 months after treatment,the BI index of the observation group was significantly higher than that of the control group(P<0.05);28days after treatment,the indexes of WBV,PV,FIB,Hcy,FBG,2hPG,TC,TG,LDL of the observation group were significantly lower than these of the control group(P<0.05),the CBF was significantly higher(P<0.05);There was no significant deference of DBP and SBP between the two groups(P>0.05).Conclusion Hydroxyethyl starch combined with atorvastatin can reduce the WBV,PV,FIB,Hcy and increase CBF of patients,so as to improve the nerve function damage.It has clinical value of popularization and application.