阿托伐他汀联合氯吡格雷对腔隙性脑梗死患者凝血功能、Hcy、hs-CRP水平、动脉粥样硬化斑块及神经功能的影响  

Effect of atorvastatin combined with clopidogrel on coagulation function,Hcy,hs-CRP levels,atherosclerotic plaque and neurological function in patients with lacunar cerebral infarction

作　　者：李燕 王春[1] 董路晨 欧伟丽 耿杰 LI Yan;WANG Chun;DONG Lu-chen(Department of General Medicine,The Second Affiliated Hospital of Bengbu Medical University,Bengbu Anhui 233000,China)

机构地区：[1]蚌埠医学院第二附属医院全科医学科,安徽蚌埠233000

出　　处：《临床和实验医学杂志》2024年第8期797-801,共5页Journal of Clinical and Experimental Medicine

基　　金：安徽省教育厅自然科学重点研究项目(编号:2022AH051456)。

摘　　要：目的 探讨阿托伐他汀联合氯吡格雷对腔隙性脑梗死(LI)患者凝血功能、同型半胱氨酸(Hcy)、超敏-C反应蛋白(hs-CRP)水平、动脉粥样硬化斑块及神经功能的影响。方法 前瞻性纳入2020年2月至2023年2月蚌埠医学院第二附属医院收治的住院或门诊的LI患者129例,按随机数字表法分为研究1组、研究2组、对照组,每组各43例。3组均给予常规治疗,在此基础上,研究1组方案为阿托伐他汀钙片20 mg/次+硫酸氢氯吡格雷片75 mg/次,研究2组方案为阿托伐他汀钙片10 mg/次+硫酸氢氯吡格雷片75 mg/次,对照组方案为阿托伐他汀钙片10 mg/次+阿司匹林肠溶片100 mg/次,4周为1个疗程,3组均治疗1个疗程。比较3组治疗前、治疗4周后的纤维蛋白原(FIB)水平、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、Hcy水平、hs-CRP水平、颈动脉内膜中层厚度(IMT)与颈动脉粥样硬化斑块数量、斑块面积。采用美国国立卫生研究院卒中量表(NIHSS)评估神经功能缺损程度,记录3组不良反应发生情况。结果 研究1组、研究2组FIB水平均低于对照组,APTT、PT均高于对照组,且研究1组FIB水平低于研究2组,APTT、PT均高于研究2组,差异均有统计学意义(P<0.05)。治疗4周后,研究1组、研究2组血清Hcy、hs-CRP水平均低于对照组,且研究1组血清Hcy、hs-CRP水平均低于研究2组,差异均有统计学意义(P<0.05)。治疗4周后,研究1组、研究2组IMT、斑块数量、斑块面积均低于对照组,且研究1组IMT、斑块数量、斑块面积均低于研究2组,差异均有统计学意义(P<0.05)。治疗4周后,研究1组、研究2组NIHSS评分均低于对照组,差异均有统计学意义(P<0.05);研究1组与研究2组NIHSS评分比较,差异无统计学意义(P>0.05)。3组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 与阿托伐他汀联合阿司匹林相比,阿托伐他汀联合氯吡格雷能进一步改善LI患者的凝血功能指标以�Objective To investigate the effects of atorvastatin combined with clopidogrel on coagulation function,homocysteine(Hcy) and hypersensitive C-reactive protein(hs-CRP) levels,atherosclerotic plaque and neurological function in patients with lacunar infarction(LI).Methods A total of 129 patients with LI who were hospitalized or outpatients in The Second Affiliated Hospital of Bengbu Medical University from February 2020 to February 2023 were divided into the study group 1,the study group 2 and the control group according to random number table method,with 43 cases in each group.All the three groups were given conventional treatment.On this basis,the study group 1 was given atorvastatin calcium tablet 20 mg/time combined with Clopidogrel bisulfate tablet 75 mg/time.The regimen of the study group 2 was atorvastatin calcium tablet 10 mg/time combined with Clopidogrel bisulfate tablet 75 mg/time.The control group was atorvastatin calcium tablet 10 mg/time+aspirin enteric-coated tablet 100 mg/time.Four weeks was a course of treatment,and all three groups received 1 course of treatment.The fibrinogen(FIB),activated partial thromboplastin time(APTT),prothrombin time(PT),Hcy levels,hs-CRP levels,carotid intimatomedia thickness(IMT) and the number and area of carotid atherosclerotic plaques were compared between the three groups before and after 4 weeks of treatment.The National Institutes of Health Stroke Scale(NIHSS) was used to evaluate the degree of neurological impairment,and the adverse reactions of the three groups were recorded.Results After 4 weeks of treatment,the FIB of the study group 1 and study group 2 were lower than those of the control group,while APTT and PT were higher than those of the control group,in addition,the FIB of the study group 1 was lower than that of the study group 2,and APTT and PT were higher than those of the study group 2,the differences were statistically significant(P<0.05).After 4 weeks of treatment,the levels of serum Hcy,hs-CRP in the study group 1 and study group 2 were lower than

关 键 词：脑梗死 阿托伐他汀 氯吡格雷 同型半胱氨酸 超敏-C反应蛋白 

分 类 号：R743.33[医药卫生—神经病学与精神病学]