阿托伐他汀联合银杏二萜内酯葡胺注射液治疗急性脑梗死的临床研究
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摘要
目的探讨应用阿托伐他汀联合银杏二萜内酯葡胺注射液治疗急性脑梗死的临床效果。方法选取2015年1月—2017年12月西宁市第一人民医院收治的急性脑梗死患者82例,随机分成对照组(41例)和治疗组(41例)。对照组静脉滴注银杏二萜内酯葡胺注射液,5 m L加入250 m L生理盐水,1次/d。治疗组在对照组基础上口服阿托伐他汀钙片,20 mg/次,1次/d。两组患者均连续治疗14 d。观察两组患者临床疗效,同时比较治疗前后两组患者总胆固醇(TC)/高密度脂蛋白胆固醇(HDL-C)、载脂蛋白(Apo)B/Apo A-l比值、国立卫生研究院卒中量表(NIHSS)评分、颈动脉超声参数及白介素(IL)-1β、IL-6、超氧化物歧化酶(SOD)和丙二醛(MDA)水平。结果治疗后,对照组和治疗组临床总有效率分别为75.6%、92.7%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清TC/HDL-C、Apo B/Apo A-l比值和NIHSS评分均显著降低(P<0.05),且治疗组上述指标显著低于对照组(P<0.05)。治疗后,两组左、右两侧颈总动脉内径、RI及IMT值较治疗前均显著降低(P<0.05),且治疗组颈动脉超声参数显著低于对照组(P<0.05)。治疗后,两组血清IL-1β、IL-6、MDA浓度较治疗前显著降低低(P<0.05),血清SOD水平显著升高(P<0.05),且治疗组IL-1β、IL-6、SOD、MDA水平明显优于对照组(P<0.05)。结论阿托伐他汀联合银杏二萜内酯葡胺注射液治疗急性脑梗死可有效改善患者神经功能,减轻机体炎性及氧化应激损伤,疗效确切。
Objective To investigate the clinical effect of atorvastatin combined with Ginkgo Biloba Diterpenoids Meglumine Injection in treatment of acute cerebral infarction. Methods Patients(82 cases) with acute cerebral infarction in Xining NO.1 People's Hospital from January 2015 to December 2017 were randomly divided into control(41 cases) and treatment(41 cases) groups. Patients in the control group were iv administered with Ginkgo Biloba Diterpenoids Meglumine Injection, 5 m L added into normal saline 250 m L, once daily. Patients in the treatment group were po administered with Atorvastatin Calcium Tablets on the basis of the control group, 20 mg/time, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the TC/HDL-C, Apo B/Apo A-l, NIHSS scores, the ultrasound parameters of carotid artery, and the IL-1β, IL-6, SOD and MDA levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 75.6% and 92.7%, respectively, and there were differences between two groups(P < 0.05). After treatment, the TC/HDL-C, Apo B/Apo A-l, and NIHSS scores in two groups were significantly decreased(P < 0.05), and these indexes in the treatment group after treatment were significantly lower than those in the control group(P < 0.05). After treatment, the left and right common carotid artery diameters, RI and IMT value in two groups were significantly decreased(P < 0.05), and the ultrasound parameters of carotid artery in the treatment group after treatment were significantly lower than those in the control group(P < 0.05). After treatment, the serum IL-1β, IL-6, MDA levels in two groups were significantly decreased(P < 0.05), serum SOD levels were significantly increased(P < 0.05), and the IL-1β, IL-6, SOD, MDA levels in the treatment group after treatment were significantly better than those in the control group(P < 0.05). Conclusion Atorvastatin combined with Ginkgo Biloba Diterpenoids Meglumine Injection in treatment of acute cerebral infarction can effectively improve the neurological function, reduce the inflammatory and oxidative stress injury, which has obvious curative effect.
Objective To investigate the clinical effect of atorvastatin combined with Ginkgo Biloba Diterpenoids Meglumine Injection in treatment of acute cerebral infarction. Methods Patients(82 cases) with acute cerebral infarction in Xining NO.1 People's Hospital from January 2015 to December 2017 were randomly divided into control(41 cases) and treatment(41 cases) groups. Patients in the control group were iv administered with Ginkgo Biloba Diterpenoids Meglumine Injection, 5 m L added into normal saline 250 m L, once daily. Patients in the treatment group were po administered with Atorvastatin Calcium Tablets on the basis of the control group, 20 mg/time, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the TC/HDL-C, Apo B/Apo A-l, NIHSS scores, the ultrasound parameters of carotid artery, and the IL-1β, IL-6, SOD and MDA levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 75.6% and 92.7%, respectively, and there were differences between two groups(P < 0.05). After treatment, the TC/HDL-C, Apo B/Apo A-l, and NIHSS scores in two groups were significantly decreased(P < 0.05), and these indexes in the treatment group after treatment were significantly lower than those in the control group(P < 0.05). After treatment, the left and right common carotid artery diameters, RI and IMT value in two groups were significantly decreased(P < 0.05), and the ultrasound parameters of carotid artery in the treatment group after treatment were significantly lower than those in the control group(P < 0.05). After treatment, the serum IL-1β, IL-6, MDA levels in two groups were significantly decreased(P < 0.05), serum SOD levels were significantly increased(P < 0.05), and the IL-1β, IL-6, SOD, MDA levels in the treatment group after treatment were significantly better than those in the control group(P < 0.05). Conclusion Atorvastatin combined with Ginkgo Biloba Diterpenoids Meglumine Injection in treatment of acute cerebral infarction can effectively improve the neurological function, reduce the inflammatory and oxidative stress injury, which has obvious curative effect.
引文
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[5]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中华神经科杂志,2010,2(2):146-153.
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[10]周婷,刘瑞珍.阿托伐他汀对急性缺血性脑卒中治疗作用研究进展[J].中西医结合心脑血管病杂志,2014,12(11):1387-1389.
[11]杨淼,汪凯.急性脑梗死患者血清超敏C反应蛋白、同型半胱氨酸水平和TC/HDL-C比值分析[J].安徽医科大学学报,2010,45(1):129-131.
[12]李旭,张飚,曹沁梅.急性缺血性脑卒中患者血清Apo B/Apo A1与NIHSS评分的相关性[J].山东医药,2015,55(10):11-13.
[13]方开峰,王本孝.急性脑梗死患者颈动脉彩超检查的临床研究[J].中华全科医学,2012,10(4):626-627.
[14]曹红元,刘雨辉,李惠允,等.急性脑梗死后炎症因子的动态变化及其与神经功能的相关性研究[J].解放军医药杂志,2014,26(3):51-54.
[15]何菊芳,李婷婷,孙晓运,等.氧化应激及炎性反应与缺血性脑卒中的关系[J].武警医学,2016,27(12):1234-1236.
[2]中国中西医结合学会神经科专业委员会.中国脑梗死中西医结合诊治指南(2017)[J].中国中西医结合杂志,2018,38(2):136-144.
[3]汪茜,冯文涛,田甜.银杏二萜内酯葡胺注射液治疗急性脑梗死临床疗效系统评价[J].中国药业,2018,27(7):56-59.
[4]刘俊平,刘苏丽,龙治华.阿托伐他汀钙联合小牛血清去蛋白注射液治疗急性脑梗死的临床研究[J].现代药物与临床,2017,32(12):2358-2362.
[5]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中华神经科杂志,2010,2(2):146-153.
[6]全国第四届脑血管病学术会议通过.脑卒中患者临床神经功能缺损程度评分标准(1995)[J].中华神经科杂志,1996,29(6):381-383.
[7]Brott T,Adams H P Jr,Olinger C P,et al.Measurements of acute cerebral infarction:a clinical examination scale[J].Stroke,1989,20(7):864-870.
[8]董斌,罗其中,徐英辉.脑缺血半暗带区研究进展[J].中华神经外科疾病研究杂志,2005,4(1):90-92.
[9]房利勤.舒血宁和银杏二萜内酯葡胺注射液药理作用比较研究[J].中国药业,2015,24(21):92-94.
[10]周婷,刘瑞珍.阿托伐他汀对急性缺血性脑卒中治疗作用研究进展[J].中西医结合心脑血管病杂志,2014,12(11):1387-1389.
[11]杨淼,汪凯.急性脑梗死患者血清超敏C反应蛋白、同型半胱氨酸水平和TC/HDL-C比值分析[J].安徽医科大学学报,2010,45(1):129-131.
[12]李旭,张飚,曹沁梅.急性缺血性脑卒中患者血清Apo B/Apo A1与NIHSS评分的相关性[J].山东医药,2015,55(10):11-13.
[13]方开峰,王本孝.急性脑梗死患者颈动脉彩超检查的临床研究[J].中华全科医学,2012,10(4):626-627.
[14]曹红元,刘雨辉,李惠允,等.急性脑梗死后炎症因子的动态变化及其与神经功能的相关性研究[J].解放军医药杂志,2014,26(3):51-54.
[15]何菊芳,李婷婷,孙晓运,等.氧化应激及炎性反应与缺血性脑卒中的关系[J].武警医学,2016,27(12):1234-1236.