PSA三联疗法对缺血性脑卒中患者颈动脉结构及血流动力学的影响

Effect of PSA triple therapy on carotid structure and hemodynamics in patients with ischemic stroke

目的探讨普罗布考、阿托伐他汀、阿司匹林(PSA)三联疗法对缺血性脑卒中患者颈动脉结构及血流动力学的影响。方法选择2016年1月至2017年3月收治的180例缺血性脑卒中患者为研究对象,采用随机数字表法分为PSA组、SA组、A组各60例,PSA组给予普罗布考、阿托伐他汀、阿司匹林联合治疗,SA组给予阿托伐他汀、阿司匹林治疗,A组给予阿司匹林治疗,随访6个月,比较两组血脂代谢、颈动脉结构与血流动力学指标。结果PSA组、SA组总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-C)均明显低于A组,高密度脂蛋白胆固醇(HDL-C)明显高于A组(P <0. 05),PSA组TG、TC、LDL-C均明显低于SA组,HDL-C明显高于SA组(P <0.05); PSA组、SA组颈动脉内-中膜厚度(IMT)、斑块面积明显小于A组,管腔直径明显大于A组(P <0. 05),PSA组IMT、斑块面积明显小于SA组,管腔直径明显大于SA组(P <0. 05); PSA组、SA组收缩期峰值血流速度(SV)、舒张期峰值血流速度(DV)均明显高于A组,阻力指数(RI)明显低于A组(P <0. 05),PSA组SV、DV明显低于PSA组,RI明显高于PSA组(P <0. 05)。结论 PSA三联疗法有助于调节缺血性脑卒中患者血脂代谢,改善颈动脉结构,提高颈动脉血流速度。

Objective To investigate the effects of combination therapy with probucol,atorvastatin and aspirin( PSA)on carotid structure and hemodynamics in patients with ischemic stroke. Methods 180 patients with ischemic stroke admitted from 2016-01 to 2017-03 were selected as subjects. They were randomly divided into PSA group,SA group and A group,60 cases in each group. PSA group was given probucol,atavastatin and aspirin were combined;group ASA was given atorvastatin and aspirin;group A was given aspirin. After 6 months of follow-up,blood lipid metabolism,carotid structure and hemodynamic parameters were compared between the two groups. Results Total cholesterol( TC),triglyceride( TG) and low density lipoprotein cholesterol( LDL-C) in PSA group and SA group were significantly lower than those in group A,and high density lipoprotein cholesterol( HDL-C) was significantly higher than that in group A( P < 0. 05). TG,TC and LDL-C in the PSA group were significantly lower than those in the SA group,and HDL-C was significantly higher than the SA group( P < 0. 05). The carotid intima-media thickness( IMT) and plaque area in the PSA group and the SA group were significantly smaller than those in the A group. The lumen diameter was significantly larger than that in the A group( P < 0. 05). The IMT and plaque area in the PSA group were significantly smaller than those in the SA group. The lumen diameter was significantly larger than that of the SA group( P < 0. 05). The peak systolic blood flow velocity( SV) and peak diastolic blood flow velocity( DV) in the PSA group and the SA group were significantly higher than those in the A group,and the resistance index( RI) was significantly lower than that in the A group( P < 0. 05). The SV and DV of the PSA group were significantly lower than those of the PSA group,and the RI was significantly higher than that of the PSA group( P < 0. 05). Conclusion PSA triple therapy can help regulate blood lipid metabolism,improve carotid structure and increase carotid blood flow velocity in patients with ischemic stroke.