他汀类药物对糖尿病性脑梗死患者侧支循环的影响  

Effects of statins on collateral circulation in patients with diabetic cerebral infarction

作　　者：潘维花 胡薇薇[3] 刘旺霞 宋裕如 Pan Weihua;Hu Weiwei;Liu Wangxia;Song Yuru(Department of Neurology,Beijing Daxing District Hospital of Integrated Traditional Chinese and Western Medicine,Beijing 100076,China)

机构地区：[1]北京市大兴区中西医结合医院神经内科,100076 [2]北京市大兴区中西医结合医院内分泌科,100076 [3]北京市丰台区南苑医院神经内科

出　　处：《北京医学》2021年第3期211-214,共4页Beijing Medical Journal

基　　金：北京市科技计划(Z161100000516205)。

摘　　要：目的探讨他汀类药物对糖尿病性脑梗死侧支循环的影响。方法回顾性分析2018年4月至2020年4月北京市大兴区中西医结合医院治疗的116例糖尿病性脑梗死患者的临床资料。所有患者均常规接受血管内介入治疗,按照是否服用他汀类药物分为口服组和未口服组,比较两组临床特征。依据侧支循环情况分为侧支循环良好组和侧支循环不良组,比较两组临床特征,进行影响糖尿病性脑梗死患者侧支循环的多因素logistic分析,比较两组预后改良Rankin量表(modified Rankin scale,mRS)评分和不良反应情况。结果口服他汀组54例,未口服组62例。口服组冠心病发生率、侧支循环良好率显著高于未口服组(59.3%比21.0%,57.4%比17.7%,P<0.05),口服组LDL-C水平低于未口服组[(2.01±0.14)mmol/L比(3.26±0.36)mmol/L,P<0.05]。侧支循环良好者42例,侧支循环不良者74例。侧支循环良好组他汀类药物服用率(66.7%)显著高于侧支循环不良组(35.1%,P<0.05);出院时美国国立卫生研究院卒中量表(National Institutes Health Stroke Scale,NIHSS)评分为(7.12±1.32)分,与侧支循环不良组[(11.09±2.16分)]相比较有所下降(P<0.05)。服用他汀类药物是影响糖尿病性脑梗死患者侧支循环的独立保护因素(OR=0.321,95%CI:0.130~0.790,P=0.013)。侧支循环良好组预后mRS评分为(2.01±0.15)分,明显低于侧支循环不良组[(2.89±0.22)分,P<0.05];不良反应总发生率也明显降低(2.4%比20.3%,P<0.05)。结论糖尿病性脑梗死患者服用他汀类药物后能有效改善侧支循环情况,同时对改善预后有一定效果。Objective To explore the effect of statins on the collateral circulatory system of diabetic cerebral infarction.Methods Clinical data of 116 patients with diabetic cerebral infarction treated in Beijing Daxing District Hospital of Integrated Traditional Chinese and Western Medicine from April 2018 to April 2020 were retrospectively analyzed.All the patients were routinely treated with endovascular interventional therapy,and were divided into the oral group and the non-oral group according to whether they took statins or not,and the clinical characteristics of the two groups were compared.According to collateral circulation,they were divided into the good collateral circulation group and the poor collateral circulation group.The clinical characteristics of the two groups were compared.Multivariate logistic analysis was performed on the influence of collateral circulation in the patients with diabetic cerebral infarction.Prognostic Modified Rankin Scale(MRS)scores and adverse reactions were compared between the two groups.Results There were 54 patients in the oral group and 62 patients in the non-oral group.The incidence of coronary heart disease and the rate of good collateral circulation in the oral group were significantly higher than those in the non-oral group(59.3%vs.21.0%,57.4%vs.17.7%,P<0.05).LDL-C level in the oral group was lower than that in the non-oral group[(2.01±0.14)mmol/L vs.(3.26±0.36)mmol/L,P<0.05].There were 42 patients in the good collateral circulation group and 74 patients in the poor collateral circulation group.The rate of statins administration in the good collateral circulation group was higher than that in the poor collateral circulation group(66.7%vs.35.1%,P<0.05).The score of National Institutes of Health Stroke Scale(NIHSS)was decreased in the good collateral circulation group than that in the poor group[(7.12±1.32)vs.(11.09±2.16),P<0.05].Statin administration was an independent protective factor for collateral circulation in the patients with diabetic cerebral infarction(OR=0.321

关 键 词：他汀类药物 糖尿病性脑梗死 侧支循环 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R587.2[医药卫生—临床医学]