不同剂量阿托伐他汀联合氯吡格雷治疗脑梗死的疗效及对凝血功能和hs-CRP的影响  

Effects of different doses of atorvastatin combined with clopidogrel on coagulation function and serum hs-CRP level in cerebral infarction patients

作　　者：马志刚[1] 闫立荣[1] 唐澍[1] Ma Zhigang Yan Lirong Tang Shu.(Jishuitan Hospital of Beijing, Beijing 100035, China)

机构地区：[1]北京积水潭医院,北京100035

出　　处：《广西医科大学学报》2017年第3期398-402,共5页Journal of Guangxi Medical University

摘　　要：目的:探讨不同剂量阿托伐他汀联合氯吡格雷治疗脑梗死的临床疗效及对凝血功能和超敏C-反应蛋白(hs-CRP)水平的影响。方法:回顾性分析2009年1月至2015年12月在北京积水潭医院接受治疗的650例脑梗死患者的临床资料,根据治疗方式不同分为观察组(n=225)和对照组(n=425)。观察组给予高剂量阿托伐他汀(40mg/d)联合氯吡格雷(75mg/d)治疗,对照组给予低剂量阿托伐他汀(20 mg/d)联合氯吡格雷(75 mg/d)治疗。比较两组患者的临床疗效及治疗前、后血小板(PLT)计数、红细胞沉降率(ESR)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB)、D-二聚体和hsCRP水平变化。结果:观察组治疗总有效率为97.41%,高于对照组的92.00%(P<0.05)。治疗前,两组PLT、ESR、APTT、PT、FIB水平比较,差异均无统计学意义(均P>0.05)。治疗后,两组PLT、APTT、PT比较,差异无统计学意义(P>0.05),但观察组ESR、FIB水平显著低于对照组(P<0.05)。两组治疗前D-二聚体、hs-CRP水平比较,差异无统计学意义(P>0.05)。治疗后,两组D-二聚体、hs-CRP水平均降低(均P<0.05),且观察组较对照组降低幅度更为显著(P<0.05)。结论:阿托伐他汀联合氯吡格雷治疗脑梗死患者的临床疗效较好,不良反应较少,安全性较高;且高剂量(40 mg/L)的阿托伐他汀在改善患者凝血功能及炎症反应程度上较低剂量(20mg/L)的阿托伐他汀更具优势,值得临床推广应用。Objective：To investigate the effects of different doses of atorvastatin combined with clopidogrel on coagulation function and serum high-sensitivity C-reactive protein （hs-CRP） level in cerebral infarction patients. Methods：Clinical data of 650 cerebral infarction patients treated in our hospital from January 2009 to December 2015 were retrospectively analyzed. Patients were divided into an observation group （ n = 225） and a control group （ n =425）,according to different treatment methods. The patients in the control group receive receive d low-dose atorvastatin （20 rag/d） and clopidogrel （75 mg/d）,while those in the observation group d high-dose atorvastatin （40 rag/d） and clopidogrel （75 rag/d）. The platelet （PLT） count,erythro- cyte sedimentation rate （ESR）,prothrombin time （PT） and activated partial thromboplastin time （APTT） as well as the serum levels of fibrinogen （FIB）, D-dimer and hs-CRP were compared between the two groups. Results. The response rate in the observation group was higher than that in the control group （97.41% vs. 92.0%, P〈0.05）. Before treatment,there were no significant differences in the PLT,ESR, APTT,PT and FIB level between the two groups （ P 〉0.05）. After treatment,the ESR and FIB level in the observation group were lower than those in the control group （ P〈0.05） ,whereas the PT,APTT and PLT count were similar in the two groups （ P〉0.05）. No significant difference was found between the two groups in the serum D-Dimer and hs-CRP levels at pretreatment （ P〉0.05）. After treatment, the serum levels of D-Dimer and hs-CRP in both groups were decreased （ P〈0.05） ,but they were more significantly decreased in the observation group （P〈0.05）.Conclusion. Atorvastatin combined with clopidogrelachieved a good curative effect for the treatment of cerebral infarction,with few adverse reactions and high safety. High-dose （40 rag/L） of atorvastatin was more effective in improving the coagulation functio

关 键 词：脑梗死 氯吡格雷 阿托伐他汀 D-二聚体 C-反应蛋白 

分 类 号：R743.33[医药卫生—神经病学与精神病学]