阿托伐他汀联合阿司匹林及氯吡格雷治疗轻中度急性脑梗死  

Clinical observation of atorvastatin combined with aspirin and clopidogrel for treatment of mild-to-moderate acute cerebral infarction

作　　者：黄玉雕[1] 王东升[1] 伞勇智 刘莹莹 徐阳 罗德欣[1] 

机构地区：[1]哈尔滨医科大学附属第五医院神经内科,黑龙江大庆163316

出　　处：《中国实用神经疾病杂志》2018年第1期30-33,共4页Chinese Journal of Practical Nervous Diseases

基　　金：黑龙江省卫生计生委研究课题(2016-149)

摘　　要：目的分析阿托伐他汀联合阿司匹林及氯吡格雷治疗轻中度急性脑梗死的临床疗效及安全性。方法收集轻中度急性脑梗死(NIHSS≤13分)住院患者120例,随机分为阿托伐他汀联合阿司匹林及氯吡格雷治疗组(观察组)、阿托伐他汀联合阿司匹林或氯吡格雷治疗组(对照1组)及阿司匹林或氯吡格雷治疗组(对照2组)各40例,疗程21d。对比各组治疗前后NIHSS评分、生活自理量表评分(ADL)、改良Rankin量表评分(mRS)、hs-CRP、血脂及不良反应发生情况。结果治疗后观察组和对照1组中TC、TG、LDL-C及hs-CRP与治疗前相比,P<0.05;治疗后观察组及对照1组TC、TG、LDL-C及hs-CRP与对照2组相比,P<0.05。治疗后观察组及对照1组NIHSS及ADL评分与对照2组相比,P<0.05。观察组及对照1组NIHSS评分增加≥4者与对照2组相比,P<0.05。结论阿托伐他汀联合阿司匹林及氯吡格雷治疗轻中度急性脑梗死的早期具有安全性高、改善不良预后、降低神经功能恶化、协同抗氧化应激及抗炎症反应等作用。Objective To analyze the clinical efficacy and safety of atorvastatin combined with aspirin and clopidogrel in the treatment of mild-to-moderate acute cerebral infarction. Methods Totally 120 cases with mild-to-moderate acute cerebral infarction （NIHSS 13 points or less） were randomly divided into atorvastatin combined aspirin and clopidogrel treatment group （observation group）,atorvastatin in combination with aspirin or clopidogrel treatment group （control group 1） and aspirin or clo- pidogrel treatment group （control group 2）, each with 40 cases, treated for 21 days. The NIHSS score, self-reliance rating scale （ADL） ,modified Rankin scale score （mRS）, hs-CRP, blood lipid and adverse reactions in the two groups were compared before and after treatment. Results After treatment,the levels of TC,TG,LDL-C and hs-CRP in observation group and control group 1 were significantly better than those before treatment （P〈0. 05） ;the observation group and the control group 1 were significantly better than those in the control group 2 （P〈0.05）. NIHSS and ADL in observation group and control group 1 were significantly better than those in control group 2 （P〈0.05）. The number of cases in which the NIHSS score 〉4 in the observation group and the control group 1 was significantly different compared with the control group 2 （P〈0.05）. Conclusion Atorvastatin combined with aspirin and clopidogrel is of high safety, can improve prognosis and decrease neurological deterioration, synergistic anti-oxida- tive stress and anti-inflammatory response in the treatment of mild-to-moderate acute cerebral infarction.

关 键 词：急性脑梗死 阿托伐他汀 阿司匹林 氯吡格雷 血脂 HS-CRP 

分 类 号：R743.33[医药卫生—神经病学与精神病学]