强化降脂治疗对急性脑梗死患者颈动脉中层厚度、斑块面积的影响  

Effect of intensive lipid-lowering therapy on carotid artery intima-media thickness and plaque area in patients with acute cerebral infarction

作　　者：孔玲 张静 牛少丽 牛晓梅 Kong Ling;Zhang Jing;Niu Shaoli;Niu Xiaomei(Department of Neurology,Changzhi Mental Health Center,Changzhi 046000,Shanxi Province,China)

机构地区：[1]长治市精神卫生中心神经内科,长治046000

出　　处：《中国基层医药》2024年第9期1322-1326,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察强化降脂治疗对急性脑梗死患者颈动脉中层厚度IMT)、斑块面积(PA)的影响。方法选择长治市精神卫生中心2021年7月至2022年7月收治的急性脑梗死患者82例为研究对象,采用随机对照临床研究方法,按照随机数字表法分为强化治疗组(41例)、常规治疗组(41例),所有患者超过溶栓时间窗,给予抗血小板聚集、神经保护等常规治疗,对照组予以常规降脂,强化治疗组予以强化降脂治疗,均持续治疗6个月,测量比较两组治疗前后血脂水平[低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)]、炎症因子[C反应蛋白(CRP)、白细胞介素6(IL-6)]、动脉粥样硬化指标(颈动脉IMT、PA),记录治疗期间患者肌痛、恶心呕吐、肝功能异常等不良反应发生情况。结果治疗前,常规治疗组与强化治疗组血脂、炎症因子、动脉粥样硬化指标差异均无统计学意义(均P>0.05);治疗后,强化治疗组LDL-C、TC水平显著低于常规治疗组[(3.44±0.42)mmol/L比(4.81±0.53)mmol/L,(3.46±0.35)mmol/L比(2.41±0.27)mmol/L](t=12.97、15.21,均P<0.05);治疗后强化治疗组血清IL-6、CRP水平显著低于常规治疗组[(4.79±0.53)mg/L比(6.97±0.81)mg/L,(38.45±4.14)pg/L比(49.66±5.07)pg/L](t=14.42、10.97,均P<0.05);治疗后强化治疗组颈动脉IMT、PA显著小于常规治疗组[(0.98±0.10)mm比(1.17±0.12)mm,(13.04±1.37)mm^(2)比(17.96±1.89)mm^(2)](t=7.79、13.50,均P<0.001);治疗期间强化治疗组与常规治疗组不良反应总发生率差异无统计学意义(P>0.05)。结论急性脑梗死患者接受强化降脂治疗效果显著,可减轻炎症反应,延缓患者动脉粥样硬化进程,且安全性与常规降脂治疗相似。Objective To investigate the effect of intensive lipid-lowering therapy on carotid artery intima-media thickness and plaque area in patients with acute cerebral infarction.Methods Eighty-two patients with acute cerebral infarction who received treatment at the Changzhi Mental Health Center from July 2021 to July 2022 were included in this study.Using a randomized controlled trial design,the patients were randomly divided into an intensive treatment group(n=41)and a conventional treatment group(n=41)using the random number table method.All patients had surpassed the recommended time window for thrombolysis and were given conventional treatments,including antiplatelet aggregation and neuroprotection.The conventional treatment group received conventional lipid-lowering therapy,while the intensive treatment group underwent intensive lipid-lowering therapy.All treatments lasted 6 months.The levels of blood lipids(low-density lipoprotein cholesterol and total cholesterol),inflammatory factors(C-reactive protein and interleukin-6),and atherosclerosis indicators(carotid artery intima-media thickness and plaque area)were measured and compared between the two groups before and after treatment.Adverse reactions occurring during the treatment period,including myalgia,nausea,vomiting,and abnormal liver function were also recorded.Results Before treatment,there were no significant differences in blood lipids,inflammatory factors or atherosclerosis indicators between the conventional treatment and intensive treatment groups(all P>0.05).After treatment,the levels of low-density lipoprotein cholesterol and total cholesterol in the intensive treatment group were significantly lower than those in the conventional treatment group[(3.44±0.42)mmol/L vs.(4.81±0.53)mmol/L,(3.46±0.35)mmol/L vs.(2.41±0.27)mmol/L,t=12.97,15.21,both P<0.05].After treatment,serum levels of interleukin-6 and C-reactive protein in the intensive treatment group were significantly lower than those in the conventional treatment group[(4.79±0.53)mg/L vs.(6.97

关 键 词：脑梗死 斑块 动脉粥样硬化 颈动脉内膜中膜厚度 降血脂药物 C反应蛋白质 白细胞介素6 

分 类 号：R743.33[医药卫生—神经病学与精神病学]