强化他汀联合早期静脉溶栓治疗急性脑梗死疗效观察

Efficacy of Intensive Statin Combined with Early Intravenous Thrombolysis in the Treatment of Acute Cerebral Infarction

目的探讨强化他汀联合早期静脉溶栓治疗急性脑梗死的临床疗效,以及对患者血清单核细胞趋化蛋白1(MCP-1)、基质金属蛋白酶9(MMP-9)及胱抑素C(CysC)水平的影响。方法选取河北省邯郸市第一医院2019年1月至12月收治的急性脑梗死患者50例,随机分为对照组和观察组,各25例。在常规对症治疗基础上,对照组患者给予标准剂量他汀联合早期静脉溶栓治疗,观察组患者给予强化他汀联合早期静脉溶栓治疗,均治疗90 d。结果观察组患者治疗总有效率高于对照组,但差异无统计学意义(P> 0.05)。治疗14 d后,两组患者总胆固醇、三酰甘油及低密度脂蛋白胆固醇水平均显著降低(P <0.05),高密度脂蛋白水平显著升高(P <0.05),且观察组较对照组改善更显著(P <0.05);两组患者的MCP-1,MMP-9,CysC水平均较治疗前显著降低(P <0.05),且观察组显著低于对照组(P <0.05)。观察组和对照组患者药品不良反应发生率相当(16.00%比8.00%, P> 0.05)。结论强化他汀联合早期静脉溶栓治疗急性脑梗死临床疗效确切,可提高患者的溶栓效果,降低血清MCP-1,MMP-9,CysC水平,促进神经功能恢复,且安全性好。

Objective To investigate the clinical efficacy of intensive statin combined with early intravenous thrombolysis in the treatment of acute cerebral infarction(ACI)and its effect on levels of serum monocyte chemoattractant protein-1(MCP-1),matrix metalloproteinase-9(MMP-9)and cystatin(CysC).Methods A total of 50 patients with ACI admitted to the First Hospital of Hand an were selected and randomly divided into the control group and the observation group,25 cases in each group.On the basis of conventional symptomatic treatment,the patients in the control group received the standard dose of statin combined with early intravenous thrombolysis,while the patients in the observation group were given intensive statin combined with early intravenous thrombolysis.Both groups were treated for 90 d.Results The total effective rate of the observation group was higher than that of the control group,but the difference was not statistically significant(P>0.05).After 14 d of treatment,the levels of total cholesterol,triglyceride and low-density lipoprotein cholesterol in the two groups decreased significantly(P<0.05),while the level of high-density lipoprotein in the two groups increased significantly(P<0.05),and those in the observation group improved significantly than those in the control group(P<0.05).The levels of MCP-1,MMP-9 and CysC in the two groups were significantly lower than those before treatment(P<0.05),and those in the observation group were significantly lower than those in the control group(P<0.05).The incidence of adverse drug reactions in the observation group was similar to that in the control group(16.00%vs.8.00%,P>0.05).Conclusion Intensive statin combined with early intravenous thrombolysis is effective and safe in the treatment of ACI.It can improve the thrombolytic effect,reduce the levels of MCP-1,MMP-9 and CysC,and promote the recovery of neurological function.