不同剂量阿托伐他汀对脑梗死患者脑血液流变学及神经功能的影响

Effects of Different Doses of Atorvastatin on Cerebral Blood Flow and Neurological Function in Patients with Cerebral Infarction

目的分析不同剂量阿托伐他汀对脑梗死患者脑血液流变学及神经功能的影响。方法选取我院自2017年7月至2020年1月收治的脑梗死患者138例,应用随机数表法分成两组,低剂量组(n=69)给予患者阿托伐他汀10mg/d,高剂量组(n=69)给予患者阿托伐他汀40 mg/d,比较两组脑循环动力学水平、血液流变学水平、运动功能评分、神经功能缺损评分、生活质量评分、用药不良反应发生率和满意度。结果治疗前,两组患者的平均血流速度、平均血流量、脑血管床特性阻抗、外周阻力水平等脑循环动力学水平之间差异无统计学意义(P>0.05);治疗后,高剂量组在平均血流速度、平均血流量、脑血管床特性阻抗、外周阻力水平等脑循环动力学水平方面的改善效果相比低剂量组更好,数据差异有统计学意义(P<0.05)。治疗前,两组患者的血浆黏度、全血黏度低切、纤维蛋白原、红细胞刚性指数等血流动力学水平方面的差异无统计学意义(P>0.05);治疗后,高剂量组的上述血流动力学指标改善效果均相比低剂量组而言具有更优的水平,数据差异有统计学意义(P<0.05)。治疗前,两组患者的运动功能、神经功能、生活质量等差异无统计学意义(P>0.05);治疗后,高剂量组患者的运动功能、神经功能、生活质量改善效果比低剂量组更好,数据差异有统计学意义(P<0.05)。经过不同治疗后,高剂量组(7例,占10.14%)患者的用药不良反应发生率和低剂量组(5例,占7.25%)患者差异无统计学意义(P>0.05)。经过治疗后,高剂量组(66例,占95.65%)对用药的满意度相比低剂量组(58例,占84.06%)而言具有更高的评价,数据差异有统计学意义(P<0.05)。结论高剂量阿托伐他汀对脑梗死患者脑血液流变学及神经功能具有有利的影响,可有效改善患者的运动功能、神经功能和生活质量,且不会产生严重的用药风险,更容易得到患者的接受和认可,临床医师可在安全范围内增加阿托伐他汀的用量,以提高治疗效果。

Objective To analyze the effect of different doses of atorvastatin on cerebral blood flow index and nerve function in patients with cerebral infarction.Methods A total of 138 patients with cerebral infarction who were treated in our hospital from July 2017 to January 2020were selected and randomly divided into two groups by digital table method.The low-dose group(n=69)was given atorvastatin 10 mg/d,the high-dose group(n=69)was given atorvastatin 40 mg/d,and the levels of cerebral circulation dynamics,blood rheology,motor function scores,neurological deficit scores,quality of life scores,and poor medication were compared between the two groups.response rate and satisfaction.Results Before treatment,there was no significant difference in the cerebral circulation dynamics levels such as average blood flow velocity,average blood flow,cerebral vascular bed characteristic impedance,and peripheral resistance level between the two groups of patients(P>0.05).After comparison,the high-dose group was compared in terms of the improvement of cerebral circulation dynamics such as average blood flow velocity,average blood flow,characteristic impedance of cerebral vascular bed,and peripheral resistance level.The low-dose group was better,and the data difference met the statistical standard(P<0.05).Before treatment,the plasma viscosity,whole blood viscosity low shear,fibrinogen,erythrocyte stiffness index and other hemodynamic levels of the patients in the two groups The difference was not significant(P>0.05).After treatment,the improvement effect of the above hemodynamic indexes in the high-dose group was better than that in the low-dose group,and the data difference met the statistical standard(P<0.05).Before treatment,there was no significant difference in motor function,neurological function,and quality of life between the two groups(P>0.05).After treatment,the motor function,neurological function,and quality of life of patients in the high-dose group improved,the effect was better than that of the low-dose group,and the data difference met the statistical standard(P<0.05).After different treatments,the incidence of adverse drug reactions in the high-dose group(7 cases,accounting for 10.14%)and the low-dose group(5 cases,accounting for 7.25%)patients had no significant statistical difference(P>0.05).After treatment,the high-dose group(66 cases,accounting for 95.65%)was more satisfied with medication than the low-dose group(58 cases,accounting for 84.06%)had a higher evaluation,and the data difference met the statistical standard(P<0.05).Conclusion High-dose atorvastatin has favorable effects on cerebral blood flow indexes and neurological function in patients with cerebral infarction,and can effectively improve patients’exercise,nerve and quality of life,without serious drug risks,and it is easier to be accepted by patients and recognized that physicians can increase the dosage of atorvastatin within a safe range to improve the therapeutic effect.