脂必泰胶囊强化降脂对脑梗死恢复期合并颈动脉斑块患者颈动脉斑块、血清炎症因子水平的影响

Effect of Zhibitai Capsule for Intensive Lipid-Lowering on Carotid Plaque and Serum Inflammatory Factor in Patients with Recovery Phase of Cerebral Infarction Complicated with Carotid Plaque

目的:探讨脂必泰胶囊强化降脂对脑梗死恢复期合并颈动脉斑块患者颈动脉斑块、血清炎症因子水平的影响。方法:选取2018年6月至2019年6月河北省第七人民医院收治的脑梗死恢复期合并颈动脉斑块患者124例,采用随机数字表法将患者分为观察组和对照组。对照组62例患者给予常规治疗联合低剂量阿托伐他汀治疗,观察组62例患者在对照组的基础上加用脂必泰胶囊强化降脂治疗,8周为1个疗程,治疗3个疗程。比较两组患者治疗前后血清炎症因子、血脂指标、颈总动脉内-中膜厚度(IMT)、最大斑块面积、血流速度、肝肾功能指标水平及中医证候评分的差异。结果:治疗后,观察组患者血清超敏C反应蛋白、脂蛋白相关磷脂酶A2和基质金属蛋白酶-9水平明显低于对照组;观察组患者血清总胆固醇、甘油三酯和低密度脂蛋白胆固醇水平明显低于对照组,高密度脂蛋白胆固醇水平明显高于对照组;观察组患者颈总动脉IMT、最大斑块面积明显小于对照组,血流速度明显快于对照组,上述差异均有统计学意义(P<0.05)。两组患者丙氨酸氨基转移酶、血肌酐和血尿素氮水平与治疗前相比的差异均无统计学意义(P>0.05)。治疗后,观察组患者中医证候评分明显低于对照组,差异有统计学意义(P<0.05)。结论:脂必泰胶囊强化降脂能够明显降低脑梗死恢复期合并颈动脉斑块患者血清炎症因子水平,调节血脂,减少颈动脉内粥样斑块,改善症状,且不会引起肝肾损伤,安全可靠。

OBJECTIVE:To probe into the effect of Zhibitai capsule for intensive lipid-lowering on carotid plaque and serum inflammatory factor in patients with recovery phase of cerebral infarction complicated with carotid plaque.METHODS:124 patients with recovery phase of cerebral infarction complicated with carotid plaque admitted into the Seventh People’s Hospital of Hebei Province from Jun.2018 to Jun.2019 were selected and divided into observation group and control group via random number table.The control group(62 cases)was given conventional therapy combined with low-dose atorvastatin,while the observation group(62 cases)was treated with Zhibitai capsule for intensive lipid-lowering based on the control group,both groups were given 3 courses of treatment(every 8 weeks for 1 course).Differences in serum inflammatory factor,blood lipid indicators,carotid intima-media thickness(IMT),maximum plaque area,blood flow velocity,indicators of hepatic and renal function,and traditional Chinese medicine(TCM)syndrome scores between two groups before and after treatment were compared.RESULTS:After treatment,the serum high-sensitivity C-reactive protein,lipoprotein-associated phospholipase A2 and matrix metalloproteinases-9 levels of observation group were significantly lower than those of the control group;the serum total cholesterol,triglyceride and low density lipoprotein cholesterin levels of observation group were significantly lower than those of the control group,while the high density lipoprotein cholesterin level was significantly higher;the carotid IMT and maximum plaque area of observation group were significantly less than those of the control group,while the blood flow velocity was significantly faster than that of the control group,with statistically significant differences(P<0.05).There was no statistical significance in differences in alanine aminotransferase,serum creatinine and blood urea nitrogen levels of both groups between before and after treatment(P>0.05).After treatment,the TCM syndrome scores of observation group was significantly lower than that of the control group,with statistically significant difference(P<0.05).CONCLUSIONS:Zhibitai capsule for intensive lipid-lowering can effectively reduce serum inflammatory factor levels in patients with recovery phase of cerebral infarction complicated with carotid plaque,which can regulate blood lipid,reduce carotid atheromatous plaque and improve symptoms,without causing hepatic and renal injury,safe and reliable.