不同剂量阿托伐他汀钙联合双联抗血小板治疗急性脑梗死的效果比较

Comparison of the effect of different doses of atorvastatin calcium combined with dual antiplatelet therapy in the treatment of acute cerebral infarction

目的比较不同剂量阿托伐他汀钙联合双联抗血小板治疗急性脑梗死的临床效果。方法选取2017年1月—2019年12月广东省台山市人民医院收治的急性脑梗死患者66例,根据随机数字表法分为研究组与对照组,各33例。对照组患者采用常规剂量阿托伐他汀钙+双联抗血小板药物(阿司匹林及氯吡格雷)治疗,研究组患者采用大剂量阿托伐他汀钙+双联抗血小板药物(阿司匹林及氯吡格雷)治疗,2组患者均连续治疗4周。比较2组患者治疗前后神经功能缺损评分(NIHSS)、颈动脉内中膜厚度(IMT)、斑块面积、超敏C反应蛋白(hs-CRP)水平、临床疗效及不良反应。结果治疗4周后,2组患者的NIHSS评分、IMT、斑块面积及hs-CRP水平均优于治疗前,且研究组患者优于对照组,差异均有统计学意义(P<0.05);2组患者的总胆固醇(TC)、三酰甘油(TG)及低密度脂蛋白(LDL-C)水平均低于治疗前,且研究组患者低于对照组,差异均有统计学意义(P<0.01)。研究组患者治疗总有效率为93.94%,高于对照组的72.73%,差异有统计学意义(χ^(2)=5.345,P=0.021)。对照组与研究组患者的不良反应总发生率比较差异无统计学意义(27.27%vs.24.24%,χ^(2)=0.079,P=0.778)。结论大剂量阿托伐他汀钙联合双联抗血小板治疗急性脑梗死可显著改善患者血脂、颈动脉粥样硬化及实验室指标,促使其神经功能恢复,从而显著提升临床疗效,有效保护脑功能,效果优于常规剂量阿托伐他汀钙。

Objective To compare the clinical effects of different doses of atorvastatin calcium combined with dual antiplatelet therapy in the treatment of acute cerebral infarction.Methods 66 patients with acute cerebral infarction admitted to Taishan People′s Hospital of Guangdong Province from January 2017 to December 2019 were selected,and they were divided into study group and control group according to the random number table method,with 33 cases in each group.The patients in the control group were treated with conventional-dose atorvastatin calcium+dual antiplatelet drugs(aspirin and clopidogrel),and the patients in the study group were treated with high-dose atorvastatin calcium+dual antiplatelet drugs(aspirin and clopidogrel),both groups were treated for 4 consecutive weeks.The neurological deficit score(NIHSS),carotid intima-media thickness(IMT),plaque area,high sensitivity C-reactive protein(hs-CRP)level,clinical efficacy and adverse reactions were compared between the two groups before and after treatment.Results After 4 weeks of treatment,the NIHSS score,IMT,plaque area and hs-CRP level of the two groups were better than those before treatment,and the study group was better than the control group,the differences were statistically significant(P<0.05);The levels of total cholesterol(TC),triacylglycerol(TG)and low density lipoprotein(LDL-C)in the two groups were lower than those before treatment,and the patients in the study group were lower than those in the control group,the differences were statistically significant(P<0.01).The total effective rate of patients in the study group was 93.94%,which was higher than 72.73%in the control group,and the difference was statistically significant(χ^(2)=5.345,P=0.021).There was no significant difference in the incidence of adverse reactions between the control group and the study group(27.27%vs.24.24%,χ^(2)=0.079,P=0.778).Conclusion High-dose atorvastatin calcium combined with dual antiplatelet therapy in the treatment of acute cerebral infarction can significantly improve blood lipids,carotid atherosclerosis and laboratory indicators,and promote the recovery of neurological function,the clinical efficacy is significantly improved,and the brain function is effectively protected,and the effect is better than the conventional-dose of atorvastatin calcium.