丁苯酞软胶囊联合瑞舒伐他汀治疗急性非心源性老年高危短暂性脑缺血发作的临床效果

Clinical effect of butylphthalide soft capsules combined with rosuvastatin in the treatment of elderly patients with acute non-cardiogenic high-risk transient ischemic attack

目的观察丁苯酞软胶囊联合瑞舒伐他汀治疗急性非心源性老年高危短暂性脑缺血发作(TIA)的临床效果。方法选取2019年1月—2021年7月江苏省徐州市第三人民医院收治的急性非心源性老年高危TIA患者72例,根据随机数字表法分为观察组(n=36)和对照组(n=36)。在常规治疗基础上,对照组给予瑞舒伐他汀治疗,观察组给予丁苯酞软胶囊联合瑞舒伐他汀治疗,2组均持续治疗6个月。比较2组治疗总有效率,治疗前后血脂、炎性因子、同型半胱氨酸(Hcy)、血液流变学指标、不稳定粥样斑块变化[颈动脉内膜—中层厚度(IMT)、Crouse积分]、生活质量评分,随访治疗后6个月脑血管病发生率。结果观察组治疗总有效率为94.44%,高于对照组的75.00%(χ^(2)=5.258,P=0.022);治疗6个月后,2组血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、Hcy水平较治疗前均降低,HDL-C水平较治疗前升高(P<0.05或P<0.01),且观察组治疗后hs-CRP、IL-6、Hcy水平均低于对照组(P<0.01);2组全血高切黏度、全血低切黏度、血浆黏度、红细胞聚集指数及纤维蛋白原水平较治疗前均降低,且观察组低于对照组(P均<0.01);观察组IMT较治疗前缩小,Crouse积分较治疗前下降,且观察组治疗后IMT小于对照组,Crouse积分低于对照组(P均<0.01);2组生活质量评分均较治疗前升高,且观察组高于对照组(P均<0.01);随访治疗后6个月,观察组脑血管病发生率为8.33%,低于对照组的27.78%(χ^(2)=4.600,P=0.032)。结论丁苯酞软胶囊联合瑞舒伐他汀治疗急性非心源性老年高危TIA患者效果显著,可调节血脂水平,改善血流动力学指标,抑制炎性因子水平和控制粥样斑块,提高患者生活质量,降低脑血管病发病率。

Objective To observe the clinical effect of butylphthalide soft capsules combined with rosuvastatin in the treatment of elderly patients with acute non-cardiogenic high-risk transient ischemic attack(TIA).Methods 72 cases of acute non-cardiogenic high-risk TIA elderly patients admitted to the Third People′s Hospital of Xuzhou from January 2019 to July 2021 were selected and divided into observation group and control group with 36 patients in each group.On the basis of routine treatment,the patients in control group were treated with rosuvastatin,and the patients in observation group were treated with butylphthalide soft capsules combined with rosuvastatin.Both groups were treated for 6 months.The therapeutic effects,changes of blood lipids,inflammatory factors,homocysteine(Hcy),hemorheology indexes,carotid intima-media thickness(IMT),crouse score and quality of life scores of the two groups were compared before and after treatment.The incidence of cerebrovascular disease was followed up for 6 months after treatment.Results The total effective rate of patients in the observation group was 94.44%,higher than 75.00%in the control group(χ^(2)=5.258,P=0.022);After 6 months of treatment,the levels of serum total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),and Hcy in both groups were lower than before treatment,and the levels of HDL-C were higher than before treatment(P<0.05 or P<0.01),the levels of hs-CRP,IL-6,and Hcy in the observation group were lower than in the control group after treatment(P<0.01);The whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,erythrocyte aggregation index and fibrinogen levels in the two groups were lower than before treatment,and the observation group was lower than the control group(P<0.01);The IMT and crouse score in the observation group were lower than before treatment,and the IMT and crouse score in the observation group were lower than in the control group(all P<0.01);The scores of quality of life in both groups were higher than before treatment,and the scores in the observation group were higher than in the control group(all P<0.01);After 6 months of follow-up treatment,the incidence of cerebrovascular disease in the observation group was 8.33%,lower than 27.78%in the control group(χ^(2)=4.600,P=0.032).Conclusion Butylphthalein soft capsules combined with rosuvastatin has a significant effect in the treatment of elderly patients with acute non-cardiogenic high-risk TIA,which can adjust the level of blood lipids,improve hemodynamic indicators,inhibit the level of inflammatory factors and control atherosclerotic plaque,improve the quality of life of patients,and reduce the incidence of cerebrovascular disease.