强化阿托伐他汀联合早期静脉溶栓治疗急性脑梗死的临床效果分析

Analysis of Clinical Effect of Intensive Atorvastatin Combined with Early Intravenous Thrombolysis in Treatment of Acute Cerebral Infarction

目的:分析强化阿托伐他汀联合早期静脉溶栓治疗急性脑梗死的临床效果。方法:选取2020年10月—2022年10月赤壁市人民医院接诊的128例急性脑梗死患者作为研究对象,根据随机数字表法分为对照组与研究组,各64例。对照组接受常规剂量阿托伐他汀联合早期静脉溶栓治疗,研究组在对照组基础上接受高剂量阿托伐他汀治疗。比较两组治疗效果。结果:治疗前,两组总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平比较,差异无统计学意义(P>0.05);治疗后,两组TC、TG、LDL-C水平低于治疗前,且研究组低于对照组,两组HDL-C水平高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05)。治疗前,两组颈动脉内膜中膜厚度(ITM)、不稳定斑块数量及斑块面积比较,差异无统计学意义(P>0.05);治疗后,两组ITM、斑块面积小于治疗前,且研究组小于对照组,两组不稳定斑块数量少于治疗前,且研究组少于对照组,差异有统计学意义(P<0.05)。治疗前,两组肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)、MMP-9水平比较,差异无统计学意义(P>0.05);治疗后,两组TNF-α、hs-CRP、MMP-9水平低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:强化阿托伐他汀联合早期静脉溶栓治疗急性脑梗死的临床效果较好,能够改善血脂水平,减轻颈动脉粥样硬化、炎性反应,降低MMP-9水平,且安全性较高。

Objective:To analyze the clinical effects of intensive atorvastatin combined with early intravenous thrombolysis in treatment of acute cerebral infarction.Methods:A total of 128 patients with acute cerebral infarction admitted to Chibi General Hospital from October 2020 to October 2022 were selected as the study subjects.According to random number table,patients were divided into control group and study group,with 64 cases in each group.The control group received atorvastatin at conventional dose and early intravenous thrombolysis,and the study group received atorvastatin at high dose on the basis of the control group.The treatment effects were compared between the two groups.Results:Before treatment,there was no significant difference in the levels of total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein choles-terol(LDL-C)between the two groups(P>0.05).After treatment,the levels of TC,TG,LDL-C in the two groups were lower than those before treatment,and the levels in the study group were lower than those in the control group,while the levels of HDL-C in the two groups were higher than those before treatment,and the levels in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in carotid intima-media thickness(ITM),number of unstable plaques and plaque area between the two groups(P>0.05).After treatment,the ITM and plaque area in the two groups were smaller than those before treatment,and these index in the study group were smaller than those in the control group,and the number of unstable plaques in the two groups was less than that before treatment,and this index in the study group was less than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the levels of tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP)and MMP-9 between the two groups(P>0.05).After treatment,the levels of TNF-α,hs-CRP and MMP-9 in the two groups were lower than those before treatment,and the levels in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Intensive atorvastatin combined with early intravenous thrombolysis in the treatment of acute cerebral infarction has a good clinical effect,and can improve blood lipid level,reduce carotid atherosclerosis and inflammatory re-action,reduce MMP-9 level,and has a high safety.