普罗布考联合匹伐他汀治疗老年高血压合并脑梗死恢复期的疗效及对患者颈动脉斑块、血脂和血清炎症因子水平的影响  

Efficacy of probucol combined with pitavastatin in the treatment of senile hypertension complicated with cerebral infarction during the recovery period and its effect on patients'carotid plaques,blood lipids and level of serum inflammatory cytokines

作　　者：黄攀登[1] 董利平[1] 郭美丹 刘杨杨 席晓霞 高云鹰[1] 吴佳宏 崔玉环[1] HUANG Pan-deng;DONG Li-ping;GUO Mei-dan(Department of Geriatrics,The First Affiliated Hospital of Hebei North University,Zhangjiakou Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院老年病科,河北张家口075000

出　　处：《临床和实验医学杂志》2023年第24期2577-2581,共5页Journal of Clinical and Experimental Medicine

基　　金：张家口市科技攻关计划项目(编号:2021045D);河北省医学科学研究课题计划(编号:20200551)。

摘　　要：目的探讨普罗布考联合匹伐他汀治疗老年高血压合并脑梗死恢复期的临床疗效以及其对患者颈动脉斑块、血脂和血清炎症因子水平的影响。方法前瞻性选取2020年6月至2021年6月河北北方学院附属第一医院收治的100例老年高血压合并脑梗死恢复期患者,以随机数字表法将其分为观察组(n=50)和对照组(n=50)。对照组口服匹伐他汀钙片(1 mg/次,1次/d)治疗,观察组在此基础上口服普罗布考片(0.25 g/次,2次/d)治疗。两组均连续治疗6个月。观察两组的疗效,比较两组治疗前、治疗6个月后的颈动脉斑块相关指标、血脂[总胆固醇、低密度脂蛋白胆固醇(LDL-C)和甘油三酯]、血清炎症因子[超敏C反应蛋白(hs-CRP)、基质金属蛋白酶-9(MMP-9)、肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6]水平,并记录两组药物不良反应情况。结果观察组总有效率为90.00%,较对照组(74.00%)显著升高,差异有统计学意义(P<0.05)。治疗6个月后,两组的颈动脉斑块面积均较治疗前显著缩小,颈动脉IMT和斑块总积分均较治疗前显著降低,且观察组颈动脉斑块面积为(16.85±4.38)mm^(2),显著小于对照组[(22.47±6.29)mm^(2)],IMT及斑块总积分分别为(0.96±0.15)mm、(3.71±1.16)分,均低于对照组[(1.13±0.17)mm、(4.28±1.30)分],差异均有统计学意义(P<0.05)。治疗6个月后,两组的血清总胆固醇、LDL-C、甘油三酯、hs-CRP、MMP-9、TNF-α及IL-6水平均较治疗前降低,且观察组血清总胆固醇、LDL-C、甘油三酯、hs-CRP、MMP-9、TNF-α及IL-6水平分别为(4.36±0.55)mmol/L、(2.69±0.36)mmol/L、(1.23±0.31)mmol/L、(1.08±0.29)mg/L、(187.62±35.73)μg/L、(22.58±6.72)pg/mL、(9.34±2.26)pg/mL,均显著低于对照组[(4.79±0.63)mmol/L、(3.17±0.47)mmol/L、(1.46±0.34)mmol/L、(1.54±0.41)mg/L、(203.88±42.39)μg/L、(29.36±8.47)pg/mL、(11.53±2.87)pg/mL],差异均有统计学意义(P<0.05)。观察组的不良反应发生率为8.00%,与对照组(4.00%),差Objective To investigate the clinical efficacy of probucol combined with pitavastatin in the treatment of senile hypertension complicated with cerebral infarction during the recovery period and its effect on patients'carotid plaques,blood lipids and level of serum inflammatory cytokines.Methods A total of 100 elderly patients with senile hypertension complicated with cerebral infarction during the recovery period in The First Affiliated Hospital of Hebei North University from June 2020 to June 2021 were prospectively selected,and divided into observation group(n=50)and control group(n=50)by method of random number table.The patients in control group were treated with oral pitavastatin calcium tablets(1 mg/time,1 time/day),while the patients in observation group were combined with probucol tablets(0.25 g/time,2 times/day)on the basis of pitavastatin calcium tablets treatment.Clinical efficacy was observed were treated continuously for 6 months.The levels of carotid plaque-related indicator,blood lipid[total cholesterol,low-density lipoprotein cholesterol(LDL-C),and triglycerides]and serum inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),matrix metalloproteinase-9(MMP-9),tumor necrosis factor-α(TNF-α)and interleukin(IL)-6]before treatment,after 6 months of treatment were analyzed between the two groups.The side effects of pharmaceutical drugs in the two groups were recorded.Results The total effective rate of the observation group was 90.00%,which was significantly higher than that of the control group(74.00%),the difference was statistically significant(P<0.05).After 6 months of treatment,the carotid plaque area of two groups was significantly smaller than that before treatment,and the carotid IMT and total plaque score were significantly lower than those before treatment,the carotid plaque area of the observation group was(16.85±4.38)mm^(2),which was significantly smaller than that of the control group[(22.47±6.29)mm^(2)],the IMT and total plaque score were(0.96±0.15)mm and(3.71±1.16)points,

关 键 词：高血压合并脑梗死 老年人 普罗布考 匹伐他汀 颈动脉斑块 血脂 炎症反应 

分 类 号：R544.1[医药卫生—心血管疾病] R743.33[医药卫生—内科学]