普罗布考联合阿托伐他汀对急性缺血性脑卒中患者的临床疗效  

Clinical efficacy of Probucol combined with Atorvastatin for patients with acute ischemic stroke

作　　者：于宁 李成博[1] 李敏[1] 纪海茹[2] 张晓璇[1] Yu Ning;Li Chengbo;Li Min;Ji Hairu;Zhang Xiaoxuan(Department of Neurology,Affiliated Hospital of Chengde Medical College,Chengde 067000,China;Department of Pathology,Chengde Medical College,Chengde 067000,China)

机构地区：[1]承德医学院附属医院神经内科,河北承德067000 [2]承德医学院病理学教研室,河北承德067000

出　　处：《中华临床医师杂志（电子版）》2021年第4期249-254,共6页Chinese Journal of Clinicians(Electronic Edition)

基　　金：2020年度河北省卫健委计划项目(20200390)。

摘　　要：目的探讨普罗布考联合阿托伐他汀对急性缺血性脑卒中患者的临床疗效及其对血清sLOX-1、Cyst-C和hs-CRP水平的影响。方法纳入承德医学院附属医院2018年10月至2019年10月期间收治的126例急性缺血性脑卒中患者为研究对象,采用随机数字表法分为观察组和对照组,各63例。对照组入院后在常规治疗的基础上给予阿托伐他汀治疗,观察组在对照组基础上联合加普罗布考进行治疗。比较2组治疗前、治疗后3个月的血脂水平、动脉粥样硬化斑块情况以及神经功能缺损(NIHSS)、自理能力(m RS)及认知功能(MMSE)等方面的差异,同时运用酶联免疫吸附法检测2组患者血清可溶性凝集素样氧化低密度脂蛋白受体-1(s LOX-1)、胱抑素C(Cyst-C)、高敏感C反应蛋白(hs-CRP)水平。随访至治疗后6个月,观察2组脑卒中复发及不良反应发生情况。结果观察组临床总有效率为93.65%,显著高于对照组的82.54%(P<0.05)。与治疗前相比,2组治疗后三酰甘油、总胆固醇、低密度脂蛋白胆固醇、载脂蛋A均明显降低,而高密度脂蛋白胆固醇则明显升高,且观察组显著优于对照组(P均<0.05)。与治疗前相比,治疗后2组NIHSS、mRS评分明显降低,MMSE评分升高,差异有统计学意义(P<0.05),且观察组NIHSS、mRS评分显著低于对照组,MMSE评分显著高于对照组(P<0.05)。2组治疗后颈动脉内中膜厚度、内膜斑块面积、易损斑块检出率均明显降低,且观察组显著低于对照组(P<0.05)。2组治疗后sLOX-1、Cyst-C和hs-CRP水平均明显降低,且观察组显著低于对照组(P<0.05)。观察组脑卒中复发率为1.58%,显著低于对照组(11.11%),差异有统计学意义(P<0.05),且2组均未出现明显不良反应。结论普罗布考联合阿托伐他汀可显著降低急性缺血性脑卒中患者的血脂水平和炎症因子水平,改善患者的神经功能、认知功能并提高生活质量,降低患者脑卒中复发的风险,安全可行,值�Objective To investigate the clinical effectiveness of Probucol combined with Atorvastatin in patients with acute ischemic stroke and its influence on serum level of sLOX-1,Cyst-C,and hs-CRP.Methods A total of 126 patients with acute ischemic stroke admitted to Affiliated Hospital of Chengde Medical College from October 2018 to October 2019 were enrolled as the study subjects,and they were divided into either an observation group(n=63)or a control group(n=63).Both groups were given Atorvastatin on the basis of conventional treatment,and the observation group was additionally given Probucol.Blood lipid levels,atherosclerotic plaques,NIHSS,mRS,and MMSE scores,and the levels of sLOX-1,Cyst-C,and hs-CRP before and at 3 month after treatment were compared between the two groups.The levels of sLOX-1,Cyst-C,and hs-CRP were detected by ELSIA.Both groups were followed for 6 months,and the recurrence rate and adverse reactions were recorded.Results The total clinical effectiveness rate in the observation group was 93.65%,which was significantly higher than that of the control group(82.54%;P<0.05).Compared with the values before treatment,triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),and apolipoprotein A(ApoA)in both groups were significantly decreased,while high density lipoprotein cholesterol(HDL-C)significantly increased after the treatment;the changes in the observation group were significantly better than those of the control group(P<0.05).Compared with the values before treatment,the NIHSS and mRS scores in both groups were significantly reduced,MMSE score increased after the treatment,and the NIHSS and mRS scores were significantly lower,while MMSE score was higher in the observation group than in the control group(P<0.05).After treatment,the carotid intima-media thickness,intimal plaque area,and the detection rate of vulnerable plaque were significantly reduced,and they were significantly lower in the observation group than in the control group(P<0.05).The levels of sLOX-1,Cyst-C,

关 键 词：急性缺血性脑卒中 可溶性凝集素样氧化低密度脂蛋白受体-1 胱抑素C 高敏感C反应蛋白 阿托伐他汀 普罗布考 

分 类 号：R743.3[医药卫生—神经病学与精神病学]