阿托伐他汀联合马来酸依那普利叶酸片治疗老年H型高血压急性脑梗死认知功能障碍的临床效果及对患者应激反应蛋白与神经元特异性烯醇化酶和S100β水平的影响

Clinical effect of atorvastatin combined with enalapril maleate folic acid tablets on cognitive impairment following acute cerebral infarction in elderly patients with H-type hypertension and the influence on stress response proteins,neuron specific enolas

目的观察阿托伐他汀联合马来酸依那普利叶酸片治疗老年H型高血压急性脑梗死认知功能障碍的临床效果及对患者应激反应蛋白及神经元特异性烯醇化酶(NSE)和S100β水平的影响。方法以2017年9月至2019年2月武汉市第一医院收治的老年H型高血压急性脑梗死认知功能障碍患者100例为研究对象,完全随机分为对照组和观察组,各50例。对照组患者接受马来酸依那普利叶酸片治疗,观察组患者接受阿托伐他汀联合马来酸依那普利叶酸片治疗。比较2组血压、同型半胱氨酸(Hcy)、认知功能、皮质醇、肾上腺素、NSE、S100β水平的变化。结果治疗后2组患者收缩压、Hcy水平较治疗前均明显降低,且观察组低于对照组[(130±10) mm Hg(1 mm Hg=0. 133 k Pa)比(137±12) mm Hg、(8. 8±1. 5)μmol/L比(10. 7±2. 2)μmol/L],差异均有统计学意义(均P <0. 05)。治疗后2组患者记忆力、注意力和计算力、回忆能力、定向力及语言能力评分较治疗前均明显升高,且观察组高于对照组,差异均有统计学意义(均P <0. 05)。治疗后2组患者皮质醇、肾上腺素、NSE、S100β水平较治疗前均明显降低,且观察组低于对照组[(199±10)μg/L比(212±9)μg/L、(91±9) ng/L比(101±10) ng/L、(2. 3±0. 5)μg/L比(3. 6±0. 5)μg/L、(2. 0±0. 5)μg/L比(2. 8±0. 5)μg/L],差异均有统计学意义(均P <0. 05)。结论阿托伐他汀联合马来酸依那普利叶酸片能有效降低老年H型高血压急性脑梗死患者血压水平,改善认知能力,并恢复患者异常的应激反应蛋白及NSE和S100β水平。

Objective To observe the clinical effect of atorvastatin combined with enalapril maleate folic acid tablets on cognitive impairment following acute cerebral infarction in elderly patients with H-type hypertension and the influence on stress response protein,neuron specific enolase( NSE) and S100β levels. Methods From September 2017 to February 2019,100 elderly patients with H-type hypertension,acute cerebral infarction and cognitive impairment admitted to Wuhan No. 1 Hospital were randomly divided into control group and observation group,with 50 cases in each group. The control group took enalapril maleate folic acid tablets. The observation group took atorvastatin and enalapril maleate folic acid tablets. Blood pressure, homocysteine, cognitive function,cortisol,adrenaline,NSE and S100β levels were analyzed. Results After treatment,systolic blood pressure and homocysteine level significantly decreased in both groups;the levels in observation group were lower than those in control group [( 130 ± 10) mmHg vs( 137 ± 12) mmHg,( 8. 8 ± 1. 5)μmol/L vs( 10. 7 ±2. 2)μmol/L]( all P < 0. 05). Scores of memory,attention and calculation,recall,orientation and language significantly increased after treatment and the scores in observation group were higher than those in control group( all P < 0. 05). Levels of cortisol,adrenaline,NSE and S100β significantly decreased after treatment and the levels in observation group were lower than those in control group[( 199 ± 10)μg/L vs( 212 ± 9)μg/L,( 91 ±9) ng/L vs( 101 ± 10) ng/L,( 2. 3 ± 0. 5)μg/L vs( 3. 6 ± 0. 5)μg/L,( 2. 0 ± 0. 5)μg/L vs( 2. 8 ± 0. 5)μg/L]( all P < 0. 05). Conclusion Atorvastatin combined with enalapril maleate folic acid tablets can effectively reduce blood pressure in elderly patients with H-type hypertension and actue cerebral infarction,improve the cognitive ability and the recovery of abnormal stress response proteins,NSE and S100β levels.