两种剂量阿托伐他汀与丁苯酞联用治疗急性脑梗死的临床研究  

Clinical study of two doses of atorvastatin combined with butylphthalide on acute cerebral infarction

作　　者：蒋辉华[1] 林琳[1] 洪卫军[1] 郑海滨[1] 

机构地区：[1]浙江省台州医院神经内科,浙江台州317000

出　　处：《实用药物与临床》2015年第9期1119-1122,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的比较常规剂量和高剂量阿托伐他汀与丁苯酞联用治疗急性脑梗死的临床疗效。方法选取我院神经内科2013年5月至2014年5月收治的急性脑梗死患者110例,采用随机数字表法分为A组(55例)和B组(55例)。A组患者采用常规剂量阿托伐他汀与丁苯酞联用治疗,B组患者则采用高剂量阿托伐他汀与丁苯酞联用治疗;比较两组患者的临床疗效,治疗前后比较美国国立卫生院卒中量表评分(NIHSS)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hsCRP)和基质金属蛋白酶-9(M M P-9)水平、颈动脉内膜中层厚度(IM T)及粥样硬化斑块面积等。结果治疗后,B组患者临床治疗总有效率高于A组(90.91%vs.60.00%,P<0.05);NIHSS评分低于A组(3.19±0.67vs.5.71±1.04,P<0.05);TC、TG、HDL-C、LDL-C、hs-CRP、M M P-9水平均优于A组(P<0.05);IM T和粥样硬化斑块面积水平均优于A组(P<0.05)。结论高剂量阿托伐他汀与丁苯酞联用治疗急性脑梗死,可有效促进神经功能恢复,抑制动脉粥样斑块形成,并有助于改善血脂指标及炎症反应水平,疗效优于低剂量阿托伐他汀。Objective To compare the clinical effects of two doses of atorvastatin combined with bu- tylphthalide on acute cerebral infarction. Methods 110 patients with acute cerebral infarction in Neurology Department in our hospital were chosen from May 2013 to May 2014 and randomly divided into 2 groups. Patients in group A （n = 55 ） were given conventional dose of atorvastatin combined with butylphthalide, patients in treatment group （ n = 55 ） were given high dose atorvastatin combined with butylphthalide treatment. The clinical efficacy, National Institutes of Health Stroke Scale （NIHSS） , total cholesterol （TC） , three glycerol （TG） , high density lipoprotein cholesterol （HDL- C ） , low density lipoprotein cholesterol （LDL-C） , high sensitive C reactive protein （hs-CRP） and matrix metalloprotei- nase-9 （MMP-9） level and carotid intimal medial thickness （IMT） and atherosclerotic plaque area before and after treatment were observed. Results The total effective rate of group B was higher than that of group A （90. 91% vs. 60.00% ,P 〈0.05）. The NIHSS score of group B was lower than that of group A （3. 19 ±0. 67 vs. 5.71 ±1.04, P 〈 0. 05 ）. The levels of TC, TG, HDL-C, LDL-C, hs-CRP, MMP-9, IMT and atherosclerotic plaque area of group B were better than those of group A （ P 〈 0. 05 ）. Conclusion Comapred with conventional dose of atorvastatin,high do- ses atorvastatin combined with butylphthalide on acute cerebral infarction can efficiently promote the recovery process of neurological function,inhibit the formation of atherosclerosis plaque, and it is helpful to improve the level of blood lipid and inflammatory reaction index.

关 键 词：阿托伐他汀 丁苯酞 急性脑梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学]