洛伐他汀联合氯吡格雷治疗急性脑梗死的临床疗效

Clinical effect of lovastatin combined with clopidogrel in the treatment of acute cerebral infarction

目的观察洛伐他汀联合氯吡格雷治疗急性脑梗死的临床疗效。方法选取2019年2—12月广东省广宁县人民医院收治的急性脑梗死患者70例,采用随机数字表法分为研究组和对照组各35例。对照组应用常规药物治疗,研究组在对照组的基础上应用洛伐他汀联合氯吡格雷治疗,2组患者均持续用药30 d。比较2组患者治疗前后基质金属蛋白酶-9(MMP-9)、血管紧张素Ⅱ(AngⅡ)、血管内皮生长因子(VEGF)、血清超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平、全血低切黏度、全血高切黏度、血浆黏度、纤维蛋白原及临床疗效。结果治疗30 d后,2组患者的MMP-9、AngⅡ水平均低于治疗前,VEGF水平均高于治疗前,且研究组降低/升高幅度大于对照组(P<0.01);2组患者的血清hs-CRP、IL-6及TNF-α水平均低于治疗前,且研究组低于对照组(P<0.01);2组患者的全血低切黏度、全血高切黏度、血浆黏度、纤维蛋白原水平均低于治疗前,且研究组低于对照组(P<0.01)。治疗30 d后,研究组患者的总有效率为91.43%,高于对照组的71.43%(χ^(2)=4.629,P=0.031)。结论洛伐他汀联合氯吡格雷治疗急性脑梗死可提高临床疗效,改善患者的血液流变学及炎性反应指标,值得进一步推广应用。

Objective To observe the clinical efficacy of lovastatin combined with clopidogrel in the treatment of acute cerebral infarction.Methods Selected 70 patients with acute cerebral infarction admitted to Guangning County People's Hospital in Guangdong Province from February to December 2019.Using random number table method,they were divided into study group and control group with 35 cases each.The control group was treated with conventional drugs,and the study group was treated with lovastatin combined with clopidogrel on the basis of the control group,patients in both groups were treated with continuous medication for 30 days.The matrix metalloproteinase-9(MMP-9),angiotensin Ⅱ(AngⅡ),vascular endothelial growth factor(VEGF),serum high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)levels,whole blood low shear viscosity,whole blood high shear viscosity,plasma viscosity,fibrinogen and clinical efficacy were compared before and after treatment between the two groups.Results After 30 days of treatment,the levels of MMP-9 and AngⅡ of the two groups were lower than those before treatment,and the levels of VEGF were higher than those before treatment,and the decrease/increasing range of the study group were greater than that of the control group(P<0.01);the serum hs-CRP,IL-6 and TNF-α levels of the two groups of patients were lower than before treatment,and the study group were lower than the control group(P<0.01);The blood low-shear viscosity,whole blood high-shear viscosity,plasma viscosity and fibrinogen level of the two groups were lower than before treatment,and the study group were lower than the control group(P<0.01).After 30 days of treatment,the total effective rate of patients in the study group was 91.43%,which was higher than 71.43% in the control group(χ^(2)=4.629,P=0.031).Conclusion Lovastatin combined with clopidogrel in the treatment of acute cerebral infarction can improve the clinical efficacy,improve the patient's hemorheology and inflammatory response indicators,and it is worthy of further promotion and application.