脑蛋白水解物和辛伐他汀对脑梗死患者颈动脉粥样斑块的疗效及对LVEF和CRP水平的影响  

Therapeutic effect of brain protein hydrolysate and simvastatin on carotid atherosclerotic plaques in CI patients and its influence on LVEF and CRP level

作　　者：杨欢[1] 张珊珊 余芾成[1] YANG Huan;ZHANG Shan-shan;YU Fei-cheng(Department of Neurology, Central Hospital of Xiaogan City, Xiaogan, Hubei, 432100, China)

机构地区：[1]孝感市中心医院神经内科

出　　处：《心血管康复医学杂志》2019年第3期352-356,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨辛伐他汀、脑蛋白水解物治疗脑梗死合并颈动脉粥样斑块患者的临床价值,及对LVEF和CRP水平的影响。方法:选择2016年3月~2017年5月于我院治疗的90例脑梗死合并颈动脉粥样斑块患者,随机均分为常规治疗组和联合治疗组(常规治疗基础上接受辛伐他汀+脑蛋白水解物治疗),治疗4周。比较两组临床疗效,治疗前后美国国立卫生研究院卒中评分量表(NIHSS)得分、颈动脉斑块相关指标、血液流变学指标、左室射血分数(LVEF)、血清C反应蛋白(CRP)及不良事件发生情况。结果:治疗后,与常规治疗组比较,联合治疗组NIHSS评分[(15.56±6.33)分比(12.14±3.18)分]、颈动脉斑块面积[(1.54±0.32)cm2比(1.34±0.30)cm2]、内膜中层厚度[(1.37±0.08)mm比(1.15±0.04)mm]均明显下降(P均<0.01),治疗总有效率(80.00%比95.56%)则显著升高(P=0.024);血液流变学指标[红细胞压积(44.24±3.24)%比(37.72±2.41)%,血小板聚集率(45.62±15.95)%比(38.10±2.52)%,纤维蛋白原(4.06±1.43)g/L比3.18±1.15)g/L,全血粘度(2.66±0.77)mPa·s比(1.55±0.25)mPa·s,血浆粘度(1.45±0.11)mPa·s比(1.21±0.16)mPa·s]、血清CRP[(4.36±1.03)mg/L比(1.70±0.20)mg/L]显著降低,而LVEF[(49.30±3.74)%比(56.67±4.37)%]则显著增加(P均<0.01);联合治疗组患者的心脑血管事件发生率显著降低(17.18%比4.44%,P=0.004)。结论:在常规治疗基础上给予脑梗死伴颈动脉粥样斑块患者辛伐他汀、脑蛋白水解物治疗,可获得更理想的总体疗效,并降低并发症发生率。Objective:To explore clinical value of brain protein hydrolysate (BPH) and simvastatin in treatment of patients with cerebral infarction (CI) complicated carotid atherosclerotic plaques (CAP). Methods:A total of 90 CI + CAP patients treated in our hospital from Mar 2016 to May 2017 were selected, randomly and equally divided into routine treatment group and combined treatment group (received simvastatin + BPH based on routine treatment), both groups were treated for four weeks. Therapeutic effect, United States National Institutes of Health Stroke Score (NIHSS), CAP-related indexes, hemorheology indexes, LVEF and CRP before and after treatment and incidence of adverse events were compared between two groups. Results:Compared with routine treatment group after treatment, there were significant reductions in NIHSS score [(15.56±6.33)scores vs.(12.14±3.18)scores], CAP size[(1.54±0.32)cm 2 vs.(1.34±0.30)cm 2 ], intima-media thickness[(1.37±0.08)mm vs.(1.15±0.04)mm]( P <0.01 all), and significant rise in total effective rate (80.00% vs. 95.56%, P =0.024) in combined treatment group;there were significant reductions in hematocrit [(44.24±3.24)% vs.(37.72±2.41)%], platelet aggregation rate [(45.62±15.95)% vs.(38.10±2.52)%], fibrinogen [(4.06±1.43)g/L vs.(3.18±1.15) g/L], whole blood viscosity [(2.66±0.77)mPa·s vs.(1.55±0.25)mPa·s], plasma viscosity [(1.45±0.11) mPa·s vs.(1.21±0.16) mPa·s]and serum CRP level [(4.36±1.03)mg/L vs.(1.70±0.20)mg/L], and significant rise in LVEF [(49.30±3.74)% vs.(56.67±4.37)%]in combined treatment group, P <0.01 all. Incidence rate of cardio- and cerebrovascular events in combined treatment group was significantly lower than that of routine treatment group (4.44% vs. 17.18%, P =0.004). Conclusion:Simvastatin combined BPH based on routine treatment can achieve better total therapeutic effect and reduce incidence rate of complications in CI + CAP patients.

关 键 词：脑梗死 蛋白水解产物 辛伐他汀 

分 类 号：R743.33[医药卫生—神经病学与精神病学]