盐酸小檗碱联合阿托伐他汀对脑梗死患者血脂水平和颈动脉粥样硬化斑块的影响  

The effects of berberine combining with atorvastatin on blood choksterol level and carotid atherosclerotic plaques in patients with acute cerebral infarction

作　　者：陈略[1] 朱飞奇[1] 刘纯钢[2] 朱瑾华[1] 

机构地区：[1]汕头大学医学院附属粤北人民医院神经内科,韶关512026 [2]汕头大学医学院附属粤北人民医院超声医学科

出　　处：《中国神经精神疾病杂志》2014年第6期348-352,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：2011年度韶关市科委课题立项(编号:韶科(卫)2011-17);2012年度广东省大学生创新训练计划立项(编号:1056012110)

摘　　要：目的观察盐酸小檗碱联合阿托伐他汀对急性脑梗死患者血脂水平和颈动脉粥样硬化斑块的影响。方法 55例急性脑梗死患者随机分为A组(n=28)、B组(n=11)、C组(n=16),分别使用阿托伐他汀20 mg/d,阿托伐他汀40 mg/d和阿托伐他汀20 mg/d+黄连素0.4g(3次/d)治疗,随访3个月,比较3组的总胆固醇(total cho-lesterol,TC)、甘油三酯(triglycerides,TG)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C),以及颈动脉粥样硬化斑块总面积(total plaque ar-ea,TPA)、斑块总最大厚度之和(Crouse积分)、内膜中层厚度(intima-media thickness,IMT)、不稳定性斑块数目的差异。结果治疗3个月后,3组的TC、TG、LDL-C均有下降,且TC和LDL-C 3组间的比较具有统计学差异(P=0.011,P=0.033);比较3组LDL-C的达标率,C组(75.0%)明显高于A组(32.1%)和B组(45.5%),差异有统计学意义(P=0.026);A、C两组均可显著降低Crouse积分(P<0.05),治疗后C组的Crouse积分明显低于A组,且两组间的比较差异具有统计学意义(P<0.05),而B组的Crouse积分出现升高。结论黄连素显著提高阿托伐他汀降低脑梗死患者LDL-C的幅度和达标率,并降低颈动脉粥样硬化斑块总最大厚度之和。Objective To observe influence of atorvastatin combining with berberine on blood cholesterol level and carotid atherosclerotic plaques in patients with acute artery atherosclerosis cerebral infarction disease. Methods Fif-ty-five cases of acute cerebral infarction patients were randomized into 3 groups： group A （n=28）, group B （n=11） and group C （n=16）. Group A, B or C received atorvastatin 20 mg （qn）, atorvastatin 40 mg （qn） or atorvastatin 20 mg （qn） ＋berberine 0.4 g （tid）, respectively. All groups were then followed up for 3 months. The total cholesterol（TC）, triglyceride （TG）, low-density lipoprotein-cholesterol （LDL-C）,high-density lipoprotein-cholesterol（HDL-C and the changes of carotid atherosclerotic plaques including total plaque area （TPA）, crouse score,carotid intima-media thickness （IMT） and the stability of carotid plaques as well as the serum levels of creatinine（Scr）, alanine aminotransferase（ALT）, aspartate aminotransferase（AST）, were compared among three groups. Results After 3 months, the TC, TG and LDL-C were de-creased in all three groups. There were statistically significant differences in the TC and LDL-C among these three groups （P=0.011,P=0.033） after treatment. The compliance rate of group C （75.0%） was significantly higher than group A （ 32.1% ） and group B （45.5%） in LDL-C （P=0.026）. Both berberine combining with atorvastatin and atorvastatin monotherapy（20mg could significantly reduce crouse score. Conclusions Berberine can significantly enhance the benefi-cial effects of atorvastatin on LDL-C and the crouse score in patients with acute artery atherosclerosis cerebral infarction patients.

关 键 词：联合降脂 盐酸小檗碱 阿托伐他汀 血脂 颈动脉粥样硬化斑块 

分 类 号：R743.3[医药卫生—神经病学与精神病学]