阿托伐他汀对腔隙性脑梗死合并CMBs患者神经功能及认知功能的影响
|
摘要
目的:探讨阿托伐他汀对腔隙性脑梗死合并脑微出血(CMBs)患者神经功能、认知功能的影响及临床疗效。方法:选取2016年1月-2017年10月本院收治的72例腔隙性脑梗死合并CMBs患者为研究对象,按照随机数字表法将患者分为对照组与观察组,每组36例。对照组给予常规保护脑细胞、改善脑部微循环、控制血压、抗血小板、抗栓及相应合并症治疗,观察组在对照组基础上给予阿托伐他汀钙片治疗。比较两组患者治疗前后神经功能、认知功能情况及临床疗效,采用屏气指数(breath-holding index,BHI)比较治疗前后两组患者脑血管反应性变化情况。结果:治疗后两组NIHSS评分均低于治疗前,MMSE评分及BHI均高于治疗前,差异均有统计学意义(P<0.05)。观察组治疗后NIHSS评分低于对照组,MMSE评分及BHI均高于对照组,差异均有统计学意义(P<0.05)。观察组总有效率88.89%明显高于对照组55.56%,差异有统计学意义(X~2=8.377,P=0.004)。结论:阿托伐他汀能够有效改善腔隙性脑梗死合并CMBs患者神经功能、认知功能水平,其临床疗效显著,值得推广应用。
Objective:To investigate the effect of Atorvastatin on nerve function and cognitive function in patients with lacunar cerebral infarction combined with cerebral microbleeds(CMBs).Method:A total of 72 cases of lacunar cerebral infarction combined with CMBs in our hospital from January 2016 to October 2017 were selected,they were divided into control group and observation group according to table of random numbers,36 cases in each group.The control group was given routine protection of brain cells,improve microcirculation,blood pressure control,antiplatelet,antithrombotic and complications of treatment.The observation group was given Atorvastatin Calcium Tablets treatment on the basis of the control group.The nerve function,cognitive function and clinical efficacy before and after the treatment were compared between the two groups,the changes of cerebral vascular reactivity before and after treatment were compared by BHI.Result:The NIHSS scores of the two groups after treatment were lower than those before treatment,the MMSE scores and BHI were significantly higher than those before treatment,the differences were statistically significant(P<0.05).After treatment,the NIHSS scores in the observation group was significantly lower than that in the control group,the MMSE scores and BHI were significantly higher than those in the control group,the differences were statistically significant(P<0.05).The total effective rate in the observation group was 88.89%,which was significantly higher than 55.56% in the control group,the difference was statistically significant( X~2=8.377,P=0.004).Conclusion:The treatment of Atorvastatin can effectively improve the level of neurological function and cognitive function in patients with lacunar infarction and CMBs,and its clinical effect is significant,which is worthy of popularization and application.
Objective:To investigate the effect of Atorvastatin on nerve function and cognitive function in patients with lacunar cerebral infarction combined with cerebral microbleeds(CMBs).Method:A total of 72 cases of lacunar cerebral infarction combined with CMBs in our hospital from January 2016 to October 2017 were selected,they were divided into control group and observation group according to table of random numbers,36 cases in each group.The control group was given routine protection of brain cells,improve microcirculation,blood pressure control,antiplatelet,antithrombotic and complications of treatment.The observation group was given Atorvastatin Calcium Tablets treatment on the basis of the control group.The nerve function,cognitive function and clinical efficacy before and after the treatment were compared between the two groups,the changes of cerebral vascular reactivity before and after treatment were compared by BHI.Result:The NIHSS scores of the two groups after treatment were lower than those before treatment,the MMSE scores and BHI were significantly higher than those before treatment,the differences were statistically significant(P<0.05).After treatment,the NIHSS scores in the observation group was significantly lower than that in the control group,the MMSE scores and BHI were significantly higher than those in the control group,the differences were statistically significant(P<0.05).The total effective rate in the observation group was 88.89%,which was significantly higher than 55.56% in the control group,the difference was statistically significant( X~2=8.377,P=0.004).Conclusion:The treatment of Atorvastatin can effectively improve the level of neurological function and cognitive function in patients with lacunar infarction and CMBs,and its clinical effect is significant,which is worthy of popularization and application.
引文
[1]韩忠奎,任明山,夏元亮,等.首发急性腔隙性脑梗死患者脑微出血与早期神经功能恶化的关联研究[J].医学研究生学报,2015,28(11):1160-1163.
[2]陈敬.缺血性脑血管病合并脑微出血的相关因素及对认知功能的影响[J/OL].临床医药文献电子杂志,2016,3(19):3757.
[3]温河.腔隙性脑梗塞采用阿托伐他汀钙联合拜阿司匹林、低分子肝素钙治疗的探析[J].中国保健营养,2016,26(18):232-233.
[4]王晓霞,鲜彤章,贾晓凡,等.2型糖尿病患者的心脑血管疾病影响因素的Nomogram分析[J].中国心血管杂志,2017,22(1):43-48.
[5]谈颂,常思远,宋波,等.早期改良美国国立卫生研究院卒中量表评分对缺血性卒中预后的预测作用[J].中华神经科杂志,2012,45(3):154-157.
[6]潘晓东,周辰,徐俊,等.认知障碍简明评价量表对老年人认知功能衰退的预测价值初探[J].中华老年心脑血管病杂志,2015,17(3):235-238.
[7]郭立军,景宏菲,曹阳,等.双重抗血小板治疗对急性脑梗死合并脑微出血患者的影响[J].中国医药导报,2016,13(11):68-71.
[8]李燕,朱向阳,王天乐,等.腔隙性脑梗死合并脑微出血临床及影像学特征研究[J].卒中与神经疾病,2016,23(4):224-227.
[9]孔德燕.腔隙性脑梗死患者脑微出血与循环内皮微粒的相关性研究[J].中华老年心脑血管病杂志,2015,17(6):610-612.
[10]杨剑宏,吴月飞.脑微出血与抗血小板治疗及脑梗死后出血转化的临床研究[J].现代实用医学,2015,27(4):442-443.
[11]姚博.腔隙性脑梗死患者脑微出血相关危险因素及其对患者认知功能的影响研究[J].中国实用医药,2017,12(23):55-56.
[12]周佳佳,徐子奇,罗本燕.进展性腔隙性脑梗死的发病机制、临床预测与治疗研究现状[J].中华神经科杂志,2013,46(7):494-495.
[13]马彩香.阿托伐他汀钙片对冠心病合并高脂血症调脂疗效观察[J].中国实用医药,2015,10(1):79-80.
[14]江美芝,冯定安,赵蔚诗,等.不同剂量阿托伐他汀钙片对脑梗死病人炎性因子和颈动脉粥样硬化的影响[J].中西医结合心脑血管病杂志,2016,14(11):1281-1284.
[15]杨漫沩,何晓玲,刘欣,等.氨氯地平联合阿托伐他汀钙片对高血压合并冠心病的治疗效果[J].贵阳医学院学报,2015,40(2):201-204.
[16]乐万明.氨氯地平阿托伐他汀钙片治疗高血压合并冠心病的疗效观察[J].实用中西医结合临床,2015,15(8):16-17.
[17]尚进,杨杰.阿托伐他汀钙片治疗脑卒中并脑微出血的临床研究[J].中国临床药理学杂志,2017,33(3):195-198.
[18]王金松.丁苯酞软胶囊联合阿托伐他汀钙片治疗脑梗塞的疗效及其对患者侧支循环建立的影响[J].医药前沿,2017,7(28):103.
[19]郭合伏,董应霞,杨芳娥.脑心通胶囊联合阿托伐他汀钙对颈动脉硬化斑块的治疗作用[J].中国医学创新,2015,12(10):45-47.
[20]李霜梅,蔡娟,石小晶,等.丁苯酞软胶囊联合阿托伐他汀钙片对脑梗死病人侧支循环建立的影响[J].中西医结合心脑血管病杂志,2017,15(1):103-105.
[2]陈敬.缺血性脑血管病合并脑微出血的相关因素及对认知功能的影响[J/OL].临床医药文献电子杂志,2016,3(19):3757.
[3]温河.腔隙性脑梗塞采用阿托伐他汀钙联合拜阿司匹林、低分子肝素钙治疗的探析[J].中国保健营养,2016,26(18):232-233.
[4]王晓霞,鲜彤章,贾晓凡,等.2型糖尿病患者的心脑血管疾病影响因素的Nomogram分析[J].中国心血管杂志,2017,22(1):43-48.
[5]谈颂,常思远,宋波,等.早期改良美国国立卫生研究院卒中量表评分对缺血性卒中预后的预测作用[J].中华神经科杂志,2012,45(3):154-157.
[6]潘晓东,周辰,徐俊,等.认知障碍简明评价量表对老年人认知功能衰退的预测价值初探[J].中华老年心脑血管病杂志,2015,17(3):235-238.
[7]郭立军,景宏菲,曹阳,等.双重抗血小板治疗对急性脑梗死合并脑微出血患者的影响[J].中国医药导报,2016,13(11):68-71.
[8]李燕,朱向阳,王天乐,等.腔隙性脑梗死合并脑微出血临床及影像学特征研究[J].卒中与神经疾病,2016,23(4):224-227.
[9]孔德燕.腔隙性脑梗死患者脑微出血与循环内皮微粒的相关性研究[J].中华老年心脑血管病杂志,2015,17(6):610-612.
[10]杨剑宏,吴月飞.脑微出血与抗血小板治疗及脑梗死后出血转化的临床研究[J].现代实用医学,2015,27(4):442-443.
[11]姚博.腔隙性脑梗死患者脑微出血相关危险因素及其对患者认知功能的影响研究[J].中国实用医药,2017,12(23):55-56.
[12]周佳佳,徐子奇,罗本燕.进展性腔隙性脑梗死的发病机制、临床预测与治疗研究现状[J].中华神经科杂志,2013,46(7):494-495.
[13]马彩香.阿托伐他汀钙片对冠心病合并高脂血症调脂疗效观察[J].中国实用医药,2015,10(1):79-80.
[14]江美芝,冯定安,赵蔚诗,等.不同剂量阿托伐他汀钙片对脑梗死病人炎性因子和颈动脉粥样硬化的影响[J].中西医结合心脑血管病杂志,2016,14(11):1281-1284.
[15]杨漫沩,何晓玲,刘欣,等.氨氯地平联合阿托伐他汀钙片对高血压合并冠心病的治疗效果[J].贵阳医学院学报,2015,40(2):201-204.
[16]乐万明.氨氯地平阿托伐他汀钙片治疗高血压合并冠心病的疗效观察[J].实用中西医结合临床,2015,15(8):16-17.
[17]尚进,杨杰.阿托伐他汀钙片治疗脑卒中并脑微出血的临床研究[J].中国临床药理学杂志,2017,33(3):195-198.
[18]王金松.丁苯酞软胶囊联合阿托伐他汀钙片治疗脑梗塞的疗效及其对患者侧支循环建立的影响[J].医药前沿,2017,7(28):103.
[19]郭合伏,董应霞,杨芳娥.脑心通胶囊联合阿托伐他汀钙对颈动脉硬化斑块的治疗作用[J].中国医学创新,2015,12(10):45-47.
[20]李霜梅,蔡娟,石小晶,等.丁苯酞软胶囊联合阿托伐他汀钙片对脑梗死病人侧支循环建立的影响[J].中西医结合心脑血管病杂志,2017,15(1):103-105.