比较阿托伐他汀和瑞舒伐他汀分别联合氯吡格雷用于脑梗死二级预防的效果  

Comparing the Effects of Atorvastatin and Rosuvastatin combined with Clopidogrel on secondary Prevention of cerebral Infarction

作　　者：王琳莉 WANG Linli(Department of Rehabilitation,Longmen Sanatorium,Luoyang Henan 471023,China)

机构地区：[1]河南省工人龙门疗养院康复科,河南洛阳471023

出　　处：《临床研究》2022年第2期52-55,共4页Clinical Research

摘　　要：目的比较阿托伐他汀和瑞舒伐他汀分别联合氯吡格雷用于脑梗死二级预防的效果。方法选择2019年3月至2021年7月在河南省工人龙门疗养院行二级预防的脑梗死患者106例,按随机数字表法分成两组,Ⅰ组和Ⅱ组,各53例。两组全部给予氯吡格雷治疗,在此基础上,Ⅰ组加用阿托伐他汀治疗,Ⅱ组加用瑞舒伐他汀治疗,连续治疗24周,比较两组不同时间段血脂指标、脑梗死复发情况、血小板聚集率、不良反应发生率。结果两组治疗后1、12、24周总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平均低于治疗前(P<0.05),治疗前后两组1、12、24周TC、TG、LDL-C水平相比较均差异无统计学意义(P>0.05);Ⅰ组脑梗死复发率为11.32%,Ⅱ组为9.43%,相比差异无统计学意义(P>0.05);两组治疗后1、12、24周血小板聚集率均低于治疗前(P<0.05),但是两组之间相同时间点血小板聚集率相比较差异无统计学意义无统计学意义(P>0.05);Ⅰ组肝功能受损和心肌酶升高率分别为3.77%、7.55%,与Ⅱ组的5.66%、5.66%相比较差异无统计学意义(P>0.05)。结论在脑梗死二级预防中应用氯吡格雷联合阿托伐他汀或瑞舒伐他汀效果均较佳,均能够发挥有效的降脂和抗血小板聚集作用,安全性和远期预防效果相当,因此临床在具体应用时需要依照患者具体情况来选择合适的治疗方案。Objective To compare the efficacy of atorvastatin and rosuvastatin combined with clopidogrel in secondary prevention of cerebral infarction.Methods A total of 106 patients with secondary prevention of cerebral infarction from March 2019 to July 2021 were randomLy divided into two groups,groupⅠand groupⅡ,with 53 cases in each.Both groups were treated with clopidogrel,on the basis of which groupⅠwas treated with atorvastatin and groupⅡwith rosuvastatin for 24 weeks,the indexes of blood lipid,recurrence of cerebral infarction,platelet aggregation rate and incidence of adverse reactions were compared between the two groups at different time.Results After 1,12 and 24 weeks of treatment,the levels of TC,TG and LDL-C in both groups were lower than those before treatment(P<0.05),TC,TG and LDL-C levels at 1,12 and 24 weeks before and after treatment were not statistically significant(P>0.05),the recurrence rate of cerebral infarction was 11.32%in groupⅠand 9.43%in groupⅡ,respectively there was not statistically significant(P>0.05).At 1,12 and 24 weeks after treatment,the platelet aggregation rate in the two groups was lower than that before treatment(P<0.05),but there was no significant difference between the two groups at the same time point(P>0.05).The rate of liver function damage and myocardial enzyme increase in groupⅠwere 3.77%and 7.55%,respectively,which had no difference compared with 5.66%and 5.66%in GroupⅡ(P>0.05).Conclusion In the secondary prevention of cerebral infarction,the effect of clopidogrel combined with atorvastatin or rosuvastatin is better,both can play an effective role in reducing blood lipid and anti-platelet aggregation,and the safety and long-term prevention effect are similar,therefore,clinical application in the specific needs of patients according to the specific circumstances to choose the appropriate treatment program.

关 键 词：氯吡格雷 阿托伐他汀 二级预防 瑞舒伐他汀 脑梗死 

分 类 号：R743.33[医药卫生—神经病学与精神病学]