阿托伐他汀对脑小血管病并认知功能损伤患者的影响
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摘要
目的探讨阿托伐他汀对脑小血管病并认知功能损伤患者的影响。方法选取2016年4月—2017年5月枣庄市峄城区人民医院收治的脑小血管病并认知功能损伤患者90例,采用随机数字表法分为对照组和观察组,每组45例。对照组患者进行常规治疗+阿司匹林、尼莫地平治疗,观察组患者在对照组基础上给予阿托伐他汀治疗;两组患者均治疗6个月。比较两组患者临床疗效,治疗前后血脂指标{包括三酰甘油(TG)、脂蛋白(a)[Lp(a)]、低密度脂蛋白胆固醇(LDL-C)及游离脂肪酸(FFA)}、蒙特利尔认知评估量表(MoCA)评分、日常生活活动能力量表(ADL)评分,观察两组患者治疗期间不良反应发生情况。结果 (1)观察组患者临床疗效优于对照组(P<0.05)。(2)治疗前两组患者TG、Lp(a)、LDL-C、FFA水平比较,差异无统计学意义(P>0.05);治疗后观察组患者TG、Lp(a)、LDL-C、FFA水平均低于对照组(P<0.05)。(3)治疗前两组患者Mo CA评分、ADL评分比较,差异无统计学意义(P>0.05);治疗后观察组患者MoCA评分、ADL评分高于对照组(P<0.05)。(4)两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论阿托伐他汀治疗脑小血管病并认知功能损伤患者的临床疗效确切,能有效降低患者血脂指标,减轻患者认知功能损伤,提高患者日常生活能力,且安全性较高。
Objective To investigate the impact of atorvastatin on cerebral small vessel disease patients complicated with cognitive impairment. Methods From April 2016 to May 2017,90 cerebral small vessel disease patients complicated with cognitive impairment were selected in the People's Hospital of Yicheng District,Zaozhuang,and they were divided into control group and observation group according to random number table method,each with 45 cases. Patients in control group received aspirin combined with nimodipine based on conventional treatment,while patients in observation group received atorvastatin based on that of control group;both groups continuously treated for 6 months. Clinical effect,blood lipids{TG, Lp(a),LDL-C,FFA},MoCA score and ADL score before and after treatment were compared between the two groups,and incidence of adverse reactions was observed during treatment. Results(1)Clinical effect in observation group was statistically significantly better than that in control group(P<0.05).(2)No statistically significant difference of levels of TG,Lp(a),LDL-C or FFA was found between the two groups before treatment(P>0.05),while levels of TG,Lp(a),LDL-C and FFA in observation group were statistically significantly lower than those in control group after treatment(P<0.05).(3)No statistically significant difference of MoCA score or ADL score was found between the two groups before treatment(P>0.05),while MoCA score and ADL score in observation group were statistically significantly higher than those in control group(P<0.05).(4)No statistically significant difference of incidence of adverse reactions was found between the two groups(P>0.05). Conclusion Atorvastatin has certain clinical effect in treating cerebral small vessel disease patients complicated with cognitive impairment,can effectively reduce the blood lipid index,relieve the cognitive impairment and improve the activity of daily living,with relatively high safety.
Objective To investigate the impact of atorvastatin on cerebral small vessel disease patients complicated with cognitive impairment. Methods From April 2016 to May 2017,90 cerebral small vessel disease patients complicated with cognitive impairment were selected in the People's Hospital of Yicheng District,Zaozhuang,and they were divided into control group and observation group according to random number table method,each with 45 cases. Patients in control group received aspirin combined with nimodipine based on conventional treatment,while patients in observation group received atorvastatin based on that of control group;both groups continuously treated for 6 months. Clinical effect,blood lipids{TG, Lp(a),LDL-C,FFA},MoCA score and ADL score before and after treatment were compared between the two groups,and incidence of adverse reactions was observed during treatment. Results(1)Clinical effect in observation group was statistically significantly better than that in control group(P<0.05).(2)No statistically significant difference of levels of TG,Lp(a),LDL-C or FFA was found between the two groups before treatment(P>0.05),while levels of TG,Lp(a),LDL-C and FFA in observation group were statistically significantly lower than those in control group after treatment(P<0.05).(3)No statistically significant difference of MoCA score or ADL score was found between the two groups before treatment(P>0.05),while MoCA score and ADL score in observation group were statistically significantly higher than those in control group(P<0.05).(4)No statistically significant difference of incidence of adverse reactions was found between the two groups(P>0.05). Conclusion Atorvastatin has certain clinical effect in treating cerebral small vessel disease patients complicated with cognitive impairment,can effectively reduce the blood lipid index,relieve the cognitive impairment and improve the activity of daily living,with relatively high safety.
引文
[1]龙建庭,游咏.尼莫地平联合阿托伐他汀治疗对血管性认知障碍患者的MDA和MMP-9影响的研究[J].卒中与神经疾病,2015,22(6):357-359.DOI:10.3969/j.issn.1007-0478.2015.06.011.
[2]马勋龙,刘洋贝,刘荣雁,等.依达拉奉联合阿托伐他汀钙对老年血管性痴呆患者血液流变学及颈动脉硬化斑块的影响[J].解放军医药杂志,2017,29(7):77-81.DOI:10.3969/j.issn.2095-140X.2017.07.021.
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[5]彭富,黄载文,梁耀武.阿托伐他汀对不同阶段血管性认知功能障碍患者血脂和认知功能的影响[J].实用临床医药杂志,2016,20(9):29-31.DOI:10.7619/jcmp.201609008.
[6]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑小血管病诊治共识[J].中华神经科杂志,2015,48(10):838-844.DOI:10.3760/cma.j.issn.1006-7876.2015.10.004.
[7]中华医学会神经病学分会痴呆与认知障碍学组写作组.血管性认知障碍诊治指南[J].中华神经科杂志,2011,44(2):142-147.DOI:10.3760/cma.j.issn.1006-7876.2011.02.017.
[8]蔡令仲,谢朝金.降脂排毒胶囊联合阿托伐他汀治疗脑梗死合并血脂异常43例[J].武警医学,2015,26(9):946-948.DOI:10.3969/j.issn.1004-3594.2015.09.027.
[9]俞波,吕望强,章群,等.美金刚、阿托伐他汀联合多奈哌齐治疗老年血管性痴呆疗效观察[J].药物流行病学杂志,2017,25(6):382-385.
[10]韩晶,成娜,徐海,等.康复训练联合阿托伐他汀对SIVD患者认知功能及日常行为能力的影响[J].现代生物医学进展,2017,17(17):3282-3284.DOI:CNKI:SUN:SWCX.0.2017-17-021.
[11]谭宝慧,刘健鹏.阿托伐他汀联合肠溶阿司匹林对短暂性脑缺血发作患者血压和血脂的影响[J].中国实验诊断学,2016,19(2):206-208.
[12]王向明,陆学胜,许敏,等.脑血管病与血管性认知障碍的相关性分析[J].中西医结合心脑血管病杂志,2016,14(20):2448-2449.DOI:10.3969/j.issn.1672-1349.2016.20.039.
[13]彭玲,孙华,罗迦,等.阿托伐他汀对高血压伴高脂血症患者凝血及内皮功能的改善[J].血栓与止血学,2017,23(2):240-242.DOI:10.3969/j.issn.1009-6213.2017.02.019.
[14]黄斌,秦怀洲.脑小血管病引发脑白质疏松与患者认知功能障碍的关系[J].河北医学,2018,24(1):174-176.DOI:10.3969/j.issn.1006-6233.2018.01.046.
[15]王潇,郭宗君,季晓云,等.血管性认知障碍发病危险因素预测模型研究[J].青岛大学医学院学报,2017,5(3):253-256.DOI:10.13361/j.qdyxy.201703001.
[16]周爱红.血管性认知功能障碍防治[J].中国实用内科杂志,2016,36(11):942-946.DOI:10.7504/nk2016100203.
[17]武建朝,张娜,陈晓虹.阿托伐他汀治疗脑小血管病伴发认知功能损害的效果观察[J].广西医科大学学报,2018,35(1):84-87.DOI:10.16190/j.cnki.45-1211/r.2018.01.023.
[2]马勋龙,刘洋贝,刘荣雁,等.依达拉奉联合阿托伐他汀钙对老年血管性痴呆患者血液流变学及颈动脉硬化斑块的影响[J].解放军医药杂志,2017,29(7):77-81.DOI:10.3969/j.issn.2095-140X.2017.07.021.
[3]卓伟东,李伟仕.阿托伐他汀联合多奈哌齐对血管性认知功能障碍患者脑血管及认知功能的影响研究[J].实用心脑肺血管病杂志,2016,24(8):32-35.DOI:10.3969/j.issn.1008-5971.2016.08.008.
[4]谭兵,陈元媛,张铭,等.阿托伐他汀钙治疗脑血管动脉粥样硬化患者的效果及作用机制[J].疑难病杂志,2017,16(5):449-452.DOI:10.3969/j.issn.1671-6450.2017.05.005.
[5]彭富,黄载文,梁耀武.阿托伐他汀对不同阶段血管性认知功能障碍患者血脂和认知功能的影响[J].实用临床医药杂志,2016,20(9):29-31.DOI:10.7619/jcmp.201609008.
[6]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑小血管病诊治共识[J].中华神经科杂志,2015,48(10):838-844.DOI:10.3760/cma.j.issn.1006-7876.2015.10.004.
[7]中华医学会神经病学分会痴呆与认知障碍学组写作组.血管性认知障碍诊治指南[J].中华神经科杂志,2011,44(2):142-147.DOI:10.3760/cma.j.issn.1006-7876.2011.02.017.
[8]蔡令仲,谢朝金.降脂排毒胶囊联合阿托伐他汀治疗脑梗死合并血脂异常43例[J].武警医学,2015,26(9):946-948.DOI:10.3969/j.issn.1004-3594.2015.09.027.
[9]俞波,吕望强,章群,等.美金刚、阿托伐他汀联合多奈哌齐治疗老年血管性痴呆疗效观察[J].药物流行病学杂志,2017,25(6):382-385.
[10]韩晶,成娜,徐海,等.康复训练联合阿托伐他汀对SIVD患者认知功能及日常行为能力的影响[J].现代生物医学进展,2017,17(17):3282-3284.DOI:CNKI:SUN:SWCX.0.2017-17-021.
[11]谭宝慧,刘健鹏.阿托伐他汀联合肠溶阿司匹林对短暂性脑缺血发作患者血压和血脂的影响[J].中国实验诊断学,2016,19(2):206-208.
[12]王向明,陆学胜,许敏,等.脑血管病与血管性认知障碍的相关性分析[J].中西医结合心脑血管病杂志,2016,14(20):2448-2449.DOI:10.3969/j.issn.1672-1349.2016.20.039.
[13]彭玲,孙华,罗迦,等.阿托伐他汀对高血压伴高脂血症患者凝血及内皮功能的改善[J].血栓与止血学,2017,23(2):240-242.DOI:10.3969/j.issn.1009-6213.2017.02.019.
[14]黄斌,秦怀洲.脑小血管病引发脑白质疏松与患者认知功能障碍的关系[J].河北医学,2018,24(1):174-176.DOI:10.3969/j.issn.1006-6233.2018.01.046.
[15]王潇,郭宗君,季晓云,等.血管性认知障碍发病危险因素预测模型研究[J].青岛大学医学院学报,2017,5(3):253-256.DOI:10.13361/j.qdyxy.201703001.
[16]周爱红.血管性认知功能障碍防治[J].中国实用内科杂志,2016,36(11):942-946.DOI:10.7504/nk2016100203.
[17]武建朝,张娜,陈晓虹.阿托伐他汀治疗脑小血管病伴发认知功能损害的效果观察[J].广西医科大学学报,2018,35(1):84-87.DOI:10.16190/j.cnki.45-1211/r.2018.01.023.