双抗血小板联合大剂量阿托伐他汀在急性脑梗死伴颈动脉狭窄患者中的疗效  

Efficacy of dual antiplatelet therapy combined with high-dose atorvastatin in patients with acute cerebral infarction and carotid stenosis

作　　者：孙新新 刘莹 韩玲 张文雅 曹雪 Sun Xinxin;Liu Ying;Han Ling;Zhang Wenya;Cao Xue(Department of Cardiovascular Medicine,964 Hospital of the PLA Joint Logistic Support Force,Changchun 130062,Jilin,China;Department of Respiratory Medicine,964 Hospital of the PLA Joint Logistic Support Force,Changchun 130062,Jilin,China;Cadres Ward,964 Hospital of the PLA Joint Logistic Support Force,Changchun 130062,Jilin,China;Medical Service Training Center,964 Hospital of the PLA Joint Logistic Support Force,Changchun 130062,Jilin,China)

机构地区：[1]解放军联勤保障部队第九六四医院心血管内科,吉林长春130062 [2]解放军联勤保障部队第九六四医院呼吸内科,吉林长春130062 [3]解放军联勤保障部队第九六四医院干部病房,吉林长春130062 [4]解放军联勤保障部队第九六四医院卫勤训练中心,吉林长春130062

出　　处：《血管与腔内血管外科杂志》2024年第8期1002-1005,共4页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨双抗血小板联合大剂量阿托伐他汀在急性脑梗死伴颈动脉狭窄患者的中的疗效。方法收集2021年3月至2023年6月于解放军联勤保障部队第九六四医院就诊的90例急性脑梗死伴颈动脉狭窄患者的临床资料,按照治疗方法的不同将其分为对照组(n=45,常规剂量阿托伐他汀+双抗血小板治疗)和观察组(n=45,大剂量阿托伐他汀+双抗血小板治疗)。比较两组患者治疗前后美国国立卫生院卒中量表(NIHSS)评分、功能综合评定量表(FCA)评分、炎性因子水平[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)]、氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSH)]变化情况。结果治疗后,两组患者NIHSS评分均低于本组治疗前,FCA评分均高于本组治疗前,且观察组患者NIHSS评分低于对照组患者,FCA评分高于对照组患者,差异均有统计学意义(P﹤0.05)。治疗后,两组患者hs-CRP、IL-6水平均低于本组治疗前,且观察组患者hs-CRP、IL-6水平均低于对照组患者,差异均有统计学意义(P﹤0.05)。治疗后,两组患者MDA均低于本组治疗前,SOD、GSH均高于本组治疗前,且观察组患者MDA低于对照组患者,SOD、GSH均高于对照组患者,差异均有统计学意义(P﹤0.05)。结论双抗血小板联合大剂量阿托伐他汀能够改善急性脑梗死伴颈动脉狭窄患者的脑神经功能,降低其炎性因子水平,改善其氧化应激反应指标,从而提高患者的生活质量,值得在临床上推广应用。Objective To investigate the efficacy of dual antiplatelet therapy combined with high-dose atorvastatin in patients with acute cerebral infarction and carotid stenosis.Method The clinical data of 90 patients with acute cerebral infarction and carotid artery stenosis who were treated at the 964 Hospital of the PLA Logistics Support Forces from March 2021 to June 2023 were collected,they were divided into two groups according to different treatment methods,the control group(n=45,conventional dose of atorvastatin plus dual antiplatelet therapy)and the observation group(n=45,high dose of atorvastatin plus dual antiplatelet therapy).The changes in the NIHSS score,FCA score,inflammatory factor levels of hypersensitive C-reactive protein(hs-CRP)and interleukin-6(IL-6),oxidative stress indicators of malondialdehyde(MDA),superoxide dismutase(SOD),glutathione(GSH)before and after treatment in the two groups of patients were compared.Result After treatment,NIHSS score in both groups were lower than those before treatment,FCA score were higher than those before treatment,and NIHSS score in observation group was lower than that of control group,FCA score was higher than control group,the differences were statistically significant(P<0.05).After treatment,the levels of hs-CRP and IL-6 in two groups were lower than those before treatment,the levels of hs-CRP and IL-6 in observation group were lower than those in control group,with statistical significance(P<0.05).After treatment,MDA in two groups were lower than those before treatment,SOD and GSH were higher than those before treatment,MDA in observation group was lower than that of control group,SOD and GSH were higher than those of control group,the differences were statistically significant(P<0.05).Conclusion The combination of dual antiplatelet and high-dose atorvastatin can improve the cerebral nerve function,reduce the level of inflammatory factors and improve the index of oxidative stress in patients with acute cerebral infarction and carotid artery stenosis,thus improvin

关 键 词：急性脑梗死伴颈动脉狭窄 双抗血小板 阿托伐他汀 

分 类 号：R543[医药卫生—心血管疾病]