氯吡格雷联合阿托伐他汀治疗急性脑梗死的效果及对血清炎症因子水平的影响  

Efficacy of clopidogrel combined with atorvastatin in the treatment of acute cerebral infarction and its effect on the levels of serum inflammatory factors

作　　者：黄丰[1] 潘晨[1] 周云芳[2] 瞿砚舟[3] HUANG Fen;PAN Chen;ZHOU Yunfan;QU Yanzhou(Department of Pharmacy,Lishui People＇s Hospital in Zhejiang Province,Lishui 323000,China;Clinical Pharma-ceutics Room,Lishui People＇s Hospital in Zhejiang Province,Lishui 323000,China;Department of Neurology,Lishui People＇s Hospital in Zhejiang Province,Lishui 323000,China)

机构地区：[1]浙江省丽水市人民医院药剂科,浙江丽水323000 [2]浙江省丽水市人民医院临床药学室,浙江丽水323000 [3]浙江省丽水市人民医院神经内科,浙江丽水323000

出　　处：《中国现代医生》2018年第23期114-117,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2015KYB457)

摘　　要：目的探讨氯吡格雷联合阿托伐他汀治疗急性脑梗死的效果及对血清炎症因子水平的影响。方法选取2016年7月～2017年10月我院急性脑梗死患者88例,分为观察组和对照组。两组患者均予以控制颅内压、血压和血糖、脑细胞保护、抗血小板聚集和改善脑部微循环等基础治疗。对照组加用氯吡格雷75 mg/次,1次/d,口服;观察组患者再加阿托伐他汀钙片20 mg/次,1次/d,口服。两组均连用8周。记录并比较两组患者治疗前后血清hs-CRP、TNF-α及IL-10指标的变化情况,比较其临床疗效。结果治疗8周后,两组患者血清hs-CRP和TNF-α显著下降,IL-10显著上升(P<0.05或P<0.01),观察组患者与对照组上升或下降幅度更显著(P<0.05);且在临床总有效率方面比较观察组较对照组更高(χ~2=5.09,P<0.05)。结论氯吡格雷联合阿托伐他汀治疗急性脑梗死的效果显著,能降低血清hs-CRP、TNF-α和IL-10水平,纠正抗炎症因子与促炎症因子比例紊乱,从而控制炎症反应。Objective To investigate the efficacy of clopidogrel combined with atorvastatin in the treatment of acute cerebral infarction and its effect on serum inflammatory factors. Methods From July 2016 to October 2017, 88 patients with acute cerebral infarction were selected and divided into observation group and control group. Both groups of pa- tients were given basic treatments such as control of intracranial pressure, blood pressure and blood glucose, brain cell protection, anti-platelet aggregation and improvement of brain microcirculation. The control group was further orally given clopidogrel of 75 mg/dose, once a day; the patients in the observation group were further orally given atorvastatin calcium tablets of 20 mg/dose, once a day. Both groups were administered for 8 weeks. The changes of serum hs-CRP, TNF-ot and IL-10 before and after treatment were recorded and compared between the two groups, and its clinical effi- cacy was compared. Results After 8 weeks of treatment, serum hs-CRP and TNF-ct were significantly decreased in both groups, and IL-10 was increased significantly（P〈0.05 or P〈0.01）. The increase or decrease in the observation group was more significant than that in the control group （P〈0.05）; in terms of the total clinical efficacy, the observation group was higher than the control group （X2=5.09, P〈0.05）. Conclusion Clopidogrel combined with atorvastatin is effec- tive in the treatment of acute cerebral infarction, which can reduce serum hs,CRP, TNF-α and IL-IO levels, correct the disordered ratio of anti-inflammatory factors and pro-inflammatory factors, so as to control the inflammatory re- sponse.

关 键 词：急性脑梗死 氯吡格雷 阿托伐他汀 炎症因子 

分 类 号：R743.3[医药卫生—神经病学与精神病学]