阿托伐他汀联合拜阿司匹林对缺血性脑卒中患者颈动脉斑块及卒中复发的影响  

Influence of Combined Therapy of Atorvastatin and Aspirin on Carotid Plaques and Recurrence Rate in Patients with Cerebral Infarction

作　　者：熊静芳[1] 傅国胜[2] 任宏宇[3] 聂晶[1] 孙文丽[1] 庞玉萍[1] 李娟[1] 

机构地区：[1]杭州市红十字会医院干部保健科,杭州310003 [2]浙江大学医学院附属邵逸夫医院心内科,杭州310020 [3]杭州市红十字会医院放射科,杭州310003

出　　处：《浙江中西医结合杂志》2016年第4期311-313,321,共4页Zhejiang Journal of Integrated Traditional Chinese and Western Medicine

基　　金：国家自然科学基金(No.81070163)

摘　　要：目的观察阿托伐他汀联合拜阿司匹林对缺血性脑卒中患者颈动脉斑块以及卒中复发的影响。方法将70例存在颈动脉斑块的缺血性脑卒中患者随机分为两组,每组35例,治疗组口服阿托伐他汀钙片及阿司匹林肠溶片;对照组口服阿司匹林肠溶片。于治疗前及治疗12个月后检查颈动脉CTA。治疗12个月后分析两组患者颈动脉斑块性质、面积及狭窄程度、血脂变化及卒中复发情况。结果治疗12个月后治疗组不稳定斑块率下降(37.1%比77.1%),斑块面积缩小[(0.19±0.21)cm^2比(0.23±0.22)cm^2],管腔狭窄率下降[(39.1±17.5)%比(49.3±19.5)%],总胆固醇以及低密度脂蛋白胆固醇水平下降[(4.39±0.32)mmol/L比(5.31±0.32)mmol/L,(1.66±0.23)mmol/L比(2.50±0.35)mmol/L],与治疗前比较差异均有统计学意义(P<0.05),与对照组[不稳定斑块率:71.4%;斑块面积:(0.21±0.22)cm2;管腔狭窄率:(46.9±18.6)%;总胆固醇:(5.22±0.32)mmol/L;低密度脂蛋白胆固醇:(2.39±0.29)mmol/L]比较差异有统计学意义(P<0.05);治疗组12个月内缺血性脑卒中复发率低于对照组(5.7%比25.7%,P<0.05)。结论阿托伐他汀联合拜阿司匹林能够稳定颈动脉斑块、减少12个月内卒中复发。Objective To evaluate the influence of combined therapy of atorvastatin and aspirin on carotid plaques in patients with cerebral infarction and the recurrence of cerebral infarction. Methods Seventy cerebral infarction patients with carotid plaque were randomly divided into two groups with each group 35 cases. Carotid CT angiography was checked before treatment and after 12 months of treatment. The patients in treatment group received combined therapy of atorvastatin and aspirin enteric-coated tablets, while patients in control group only took aspirin enteric coated tablet. The effects of atorvastatin and aspirin treatment on carotid plaques, degree of carotid artery luminal narrowing, blood lipid level and recurrence of cerebral infarction were evaluated after 12 months of treatment. Results Compared with pre-therapy and control group, unstable plaques rate（37.1% vs 77.1% and71.4%）, plaque area（0.19±0.21cm2 vs 0.23±0.22cm-2 and 0.21±0.22cm-2） and the degree of carotid artery luminal narrowing（39.1%±17.5% vs 49.3%±19.5% and 46.9%±18.6%） reduced, and the levels of total cholesterol（4.39±0.32mmol/L vs 5.31±0.32mmol/L and 5.22±0.32mmol/L） and low density lipoprotein cholesterol（1.66±0.23mmol/L vs2.50±0.35mmol/L and 2.39±0.29mmol/L） reduced in treatment group after 12 months of treatment（all P〈0.05）. The recurrence rate of cerebral infarction within 12 months in treatment group significantly reduced compared to control group（5.7% vs 25.7%, P〈0.05）. Conclusion The combined therapy of atorvastatin and aspirin enteric-coated tablets could stabilize carotid plaque and reduce the recurrence rate of cerebral infarction within 12 months.

关 键 词：缺血性脑卒中 颈动脉斑块 阿托伐他汀 拜阿司匹林 复发 

分 类 号：R743.3[医药卫生—神经病学与精神病学]