阿托伐他汀的使用时机对脑血栓患者神经功能及血液黏稠度的影响分析
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摘要
目的:探讨阿托伐他汀使用时机对脑血栓患者神经功能及血液黏稠度的影响。方法 :选择2016年3月—2017年12月我院收治的脑血栓患者78例作为研究对象,所有患者均采用阿托伐他汀治疗,根据药物使用时机不同分为对照组和观察组,各39例。对照组早餐后2 h口服阿托伐他汀(20 mg)治疗,观察组在晚餐后2 h口服阿托伐他汀(40 mg)治疗,两组均治疗12周。比较两组疗效,采用神经功能缺损量表(NFDS)、改良的Rankin量表(m RS)及日常生活活动(ADL)量表评估两组神经功能、日常生活能力;采用脑循环血流动力学监测仪测定两组治疗前、后血液黏稠度指标;比较两组治疗后心源性死亡、心律失常、心肌梗死发生率。结果:治疗后两组NFDS、mRS评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P <0.05);治疗后两组ADL评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P <0.05);治疗后两组血液黏稠度水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P <0.05);治疗后12周观察组心源性死亡、心律失常、心肌梗死发生率均低于对照组,差异有统计学意义(P <0.05)。结论:阿托伐他汀片晚餐后2h用药治疗脑血栓有助于提高患者神经功能,改善血液黏稠度,降低心血管事件发生率,值得推广应用。
Objective: To explore the effect of atorvastatin use occasion on neurological function and blood viscosity of patients with cerebral thrombosis. Methods: 78 patients with cerebral thrombosis admitted to our hospital from March 2016 to December 2017 were selected as subjects investigated, and all patients were treated with atorvastatin and divided into a control group and an observation group according to drug use occasion, 39 cases each. The patients in the control group were treated with oral atorvastatin(20 mg) at 2 h after breakfast, and the patients in the observation group were treated with oral atorvastatin(40 mg) at 2 h after supper. The patients in the two groups were treated for 12 weeks. The efficacy was compared between the two groups. The neurological functions and daily living ability in the two groups were evaluated by neurological function defect scale(NFDS), modified Rankin scale(mRS) and scale of activities of daily living(ADL). The blood viscosity indexes in the two groups before and after treatment were measured with a cerebral circulation hemodynamic monitor. The incidences of cardiac death, arrhythmia and myocardial infarction were compared between the two groups. Results: The scores of NFDS and mRS in the two groups after treatment were lower than those before treatment, and the scores in the observation group were lower than those in the control group, with statistically significant differences(P<0.05). The scores of ADL in the two groups after treatment were higher than those before treatment, and the scores in the observation group were higher than those in the control group, with statistically significant difference(P<0.05). The level of blood viscosity in the two groups after treatment was lower than that before treatment, and the level in the observation group was lower than that in the control group, with statistically significant differences(P<0.05). The incidences of cardiac death, arrhythmia and myocardial infarction in the observation group were lower than those in the control group after 12 weeks of treatment(P<0.05). Conclusion: Atorvastatin tablets used at 2 h after supper can improve neurological function, improve blood viscosity and reduce the incidence of cardiovascular events in the patients with cerebral thrombosis, which are worthy of promotion and application.
Objective: To explore the effect of atorvastatin use occasion on neurological function and blood viscosity of patients with cerebral thrombosis. Methods: 78 patients with cerebral thrombosis admitted to our hospital from March 2016 to December 2017 were selected as subjects investigated, and all patients were treated with atorvastatin and divided into a control group and an observation group according to drug use occasion, 39 cases each. The patients in the control group were treated with oral atorvastatin(20 mg) at 2 h after breakfast, and the patients in the observation group were treated with oral atorvastatin(40 mg) at 2 h after supper. The patients in the two groups were treated for 12 weeks. The efficacy was compared between the two groups. The neurological functions and daily living ability in the two groups were evaluated by neurological function defect scale(NFDS), modified Rankin scale(mRS) and scale of activities of daily living(ADL). The blood viscosity indexes in the two groups before and after treatment were measured with a cerebral circulation hemodynamic monitor. The incidences of cardiac death, arrhythmia and myocardial infarction were compared between the two groups. Results: The scores of NFDS and mRS in the two groups after treatment were lower than those before treatment, and the scores in the observation group were lower than those in the control group, with statistically significant differences(P<0.05). The scores of ADL in the two groups after treatment were higher than those before treatment, and the scores in the observation group were higher than those in the control group, with statistically significant difference(P<0.05). The level of blood viscosity in the two groups after treatment was lower than that before treatment, and the level in the observation group was lower than that in the control group, with statistically significant differences(P<0.05). The incidences of cardiac death, arrhythmia and myocardial infarction in the observation group were lower than those in the control group after 12 weeks of treatment(P<0.05). Conclusion: Atorvastatin tablets used at 2 h after supper can improve neurological function, improve blood viscosity and reduce the incidence of cardiovascular events in the patients with cerebral thrombosis, which are worthy of promotion and application.
引文
[1]李秀芹,高勇.阿托伐他汀联合尤瑞克林对急性脑梗死患者临床疗效及内皮素水平的影响[J].中国老年学杂志,2016,36(9)2146-2148.
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[4]关晖勇,黄眧海,陈愉快.阿托伐他汀联合甲钴胺对脑梗死患者C反应蛋白、同型半胱氨酸和血脂的调控作用[J].实用医学杂志,2016,32(4):640-642.
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[6]Schuchardt F,Hennemuth A,Schroeder L,et al.Acute Cerebral Venous Thrombosis:Three-Dimensional Visualization and Quantification of Hemodynamic Alterations Using4-Dimensional Flow Magnetic Resonance Imaging[J].Stroke,2017,48(3):671-677.
[7]高菊华,高小平,潘速跃.阿托伐他汀强化治疗可减少大脑中动脉支架置入后脑血管事件的发生[J].南方医科大学学报,2016,36(3):356-360.
[8]顾金金,刘强,毛善奎.阿托伐他汀对稳定期COPD患者肺功能、肺动脉压及相关指标影响的Meta分析[J].中国药房,2017,28(33):4682-4685.
[9]刘洁,陈祖平,陈见红,等.阿托伐他汀对急性ST段抬高型心肌梗死患者外周血内皮祖细胞表面标志物表达的影响[J].中国病理生理杂志,2017,33(5):851-856.
[10]杨焱.不同剂量阿托伐他汀对老年血脂正常冠心病患者炎症、心功能及心血管事件的影响[J].中国老年学杂志,2016,36(17):4208-4210.
[11]杨伟,腾林,喻红.依泽替米贝联合阿托伐他汀对动脉粥样硬化斑块的影响[J].中国医院药学杂志,2016,36(22):2007-2011.
[12]Kang JH,Yun TJ,Yoo RE,et al.Bright sinus appearance on arterial spin labeling MR imaging aids to identify cerebral venous thrombosis[J].Medicine(Baltimore),2017,96(41):e8244.
[13]谢莲娜,王丽君,王凯君,等.单次大剂量阿托伐他汀对不稳定性心绞痛患者血管内皮功能及Rho激酶活性的影响[J].中国循环杂志,2016,31(8):746-749.
[2]?etin S,Vural MG,Gündüz H,et al.Epicardial fat thickness regression with continuous positive airway pressure therapy in patients with obstructive sleep apnea:assessment by twodimensional echocardiography[J].Wien Klin Wochenschr,2016,128(5-6):187-192.
[3]张艳影,石振东.停用阿托伐他汀对老年急性脑梗死患者颈动脉易损斑块及预后的影响研究[J].中国全科医学,2017,20(28):3509-3514.
[4]关晖勇,黄眧海,陈愉快.阿托伐他汀联合甲钴胺对脑梗死患者C反应蛋白、同型半胱氨酸和血脂的调控作用[J].实用医学杂志,2016,32(4):640-642.
[5]王映林,李青叶.辛伐他汀对脑梗死患者神经功能及预后的影响[J].中国药房,2017,28(26):3708-3710.
[6]Schuchardt F,Hennemuth A,Schroeder L,et al.Acute Cerebral Venous Thrombosis:Three-Dimensional Visualization and Quantification of Hemodynamic Alterations Using4-Dimensional Flow Magnetic Resonance Imaging[J].Stroke,2017,48(3):671-677.
[7]高菊华,高小平,潘速跃.阿托伐他汀强化治疗可减少大脑中动脉支架置入后脑血管事件的发生[J].南方医科大学学报,2016,36(3):356-360.
[8]顾金金,刘强,毛善奎.阿托伐他汀对稳定期COPD患者肺功能、肺动脉压及相关指标影响的Meta分析[J].中国药房,2017,28(33):4682-4685.
[9]刘洁,陈祖平,陈见红,等.阿托伐他汀对急性ST段抬高型心肌梗死患者外周血内皮祖细胞表面标志物表达的影响[J].中国病理生理杂志,2017,33(5):851-856.
[10]杨焱.不同剂量阿托伐他汀对老年血脂正常冠心病患者炎症、心功能及心血管事件的影响[J].中国老年学杂志,2016,36(17):4208-4210.
[11]杨伟,腾林,喻红.依泽替米贝联合阿托伐他汀对动脉粥样硬化斑块的影响[J].中国医院药学杂志,2016,36(22):2007-2011.
[12]Kang JH,Yun TJ,Yoo RE,et al.Bright sinus appearance on arterial spin labeling MR imaging aids to identify cerebral venous thrombosis[J].Medicine(Baltimore),2017,96(41):e8244.
[13]谢莲娜,王丽君,王凯君,等.单次大剂量阿托伐他汀对不稳定性心绞痛患者血管内皮功能及Rho激酶活性的影响[J].中国循环杂志,2016,31(8):746-749.