血栓通联合阿托伐他汀治疗对短暂性脑缺血发作患者颈动脉粥样硬化斑块、血脂及血流变的影响  

Xueshuantong Combined with Atorvastatin on Carotid Atherosclerosis Plaque,Blood Lipid and Hemorheology in TIA Patients with Carotid Atherosclerosis

作　　者：薛庆华[1] 武能坤 李鹏[1] 王莹莹 许瑞卿[1] 李婧 XUE Qinghua;WU Nengkun;LI Peng;WANG Yingying;XU Ruiqing;LI Jing(Chuzhou Hospital of Intergrated Chinese and Western Medicine, Chuzhou 239000, Anhui, Chin)

机构地区：[1]滁州市中西医结合医院脑病二科

出　　处：《中华中医药学刊》2018年第4期1014-1018,共5页Chinese Archives of Traditional Chinese Medicine

摘　　要：目的：观察血栓通联合阿托伐他汀治疗对伴有颈动脉粥样硬化的短暂性脑缺血发作患者的颈动脉粥样硬化斑块、血脂及血流变的影响。方法：选择2015年7月—2016年7月期间住院的短暂性脑缺血发作患者68例为观察对象,所有患者经彩色多普勒超声检查证实颈动脉存在粥样斑块,随机分为观察组与对照组,每组34名患者。均给予短暂性脑缺血发作的常规治疗,对照组患者额外给予阿托伐他汀钙片20 mg口服,1次/晚;观察组患者在此基础上给予血栓通450 mg静脉滴注,1次/d,10 d为1疗程,在半年内完成5~6个疗程。随访跟踪半年。在治疗开始前及随访至半年时,记录患者的短暂性脑缺血发作发作频率、时间变化,行颈动脉超声检查,测量粥样硬化斑块面积及动脉内膜中层厚度,抽血检查患者的血脂水平及血流变指标。结果：经过治疗,观察组患者TIA发作平均（0.70±0.79）次/d,发作时间为（5.60±3.78）min/次,对照组平均（1.40±0.77）次/d,（7.83±4.69）min/次;观察组患者的血脂水平为：胆固醇（4.81±1.18）mmol/L,甘油三酯（2.19±0.37）mmol/L,低密度脂蛋白（3.28±0.59）mmol/L,高密度脂蛋白（1.38±0.37）mmol/L,对照组分别为（5.64±1.25）mmol/L、（2.64±0.42）mmol/L、（3.70±0.68）mmol/L、（1.20±0.30）mmol/L;观察组患者的颈动脉内膜中层厚度为（1.13±0.23）mm,颈动脉斑块面积为（15.21±6.95）mm 2,对照组分别为（1.28±0.34）mm,（18.90±6.37）mm 2;观察组患者的红细胞压积（%）为（41.74±3.92）,血小板计数（×10 9/L）为（254.80±85.27）,纤维蛋白原（g/L）为（3.26±0.52）,对照组分别为（44.46±5.02）、（293.73±58.16）、（3.61±0.76）。均较接受治疗前明显下降（HDL升高）（P〈0.05）。两组治疗后结果相比,观察组患者各项指标比对照组下降（升高）更为明显（P〈0.05）,治疗效果更好。结论：对伴有颈动脉粥样硬化的短暂性�Objective： To observe the effect of Xueshuantong combined with atorvastatin on carotid atherosclerosis plaque,blood lipid and hemorheology in TIA patients with carotid atherosclerosis. Method： From July 2015 to July 2016,68 patients with TIA were selected as observation objects. All patients had carotid atherosclerotic plaques,confirmed by color Doppler ultrasound examination. The patients were randomly divided into observation group and control group,34 patients in each group. All patients were given conventional treatment of TIA and patients in the control group given Atorvastatin Calcium Tablets 20 mg orally,1 times/night. On this basis,patients in the observation group were given Xueshuantong 450 mg intravenous drip,1 times/day,10 days for a course of treatment,and within six months patients received 5-6 treatment courses and were followed up for half a year. Before the start of treatment and follow-up for six months,the frequency and time of onset of TIA were recorded,receiving carotid artery ultrasonography to measure atherosclerotic plaque area and intima media thickness,blood lipid level and hemorheology in patients were measured. Result：After treatment,the observation group＇s TIA attack on average was（ 0. 70 ± 0. 79） times/day and the attack time（ 5. 60± 3. 78） min. The control group＇s TIA attack on average was（ 1. 40 ± 0. 77） times/day and the attack time（ 7. 83 ±4. 69） minutes. The blood lipid levels of the patients in the observation group were cholestero（ 14. 81 ± 1. 18） mmol/L,triglyceride（ 2. 19 ± 0. 37） mmol/L,low density lipoprotein（ LDL）（ 3. 28 ± 0. 59） mmol/L,high density lipoprotein（ HDL）（ 1. 38 ± 0. 37） mmol/L and the control group＇s were（ 5. 64 ± 1. 25） mmol/L,（ 2. 64 ± 0. 42） mmol/L,（ 3. 70 ±0. 68） mmol/L and（ 1. 20 ± 0. 30） mmol/L. The carotid intima media thickness of the observation group was（ 1. 13 ±0. 23） mm and the carotid plaque area was（ 15. 21 ± 6. 95） mm^2. The control group＇s was（ 1. 28

关 键 词：血栓通 阿托伐他汀 TIA 颈动脉粥样硬化斑块 血脂 血液流变学 

分 类 号：R743.31[医药卫生—神经病学与精神病学]