阿托伐他汀钙治疗急性缺血性脑梗死的临床疗效及对血浆溶血磷脂酸水平的影响
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摘要
目的:研究阿托伐他汀钙对急性缺血性脑梗死的治疗效果及血浆溶血磷脂酸(LPA)水平的影响。方法:随机数字法将96例急性缺血性脑梗死患者分为观察组与对照组,各48例。对照组给予常规治疗,观察组在对照组基础上加以阿托伐他汀钙治疗。比较两组临床疗效、治疗前后NIHSS评分、血脂指标、血浆LPA水平及血清炎性反应因子变化,评价治疗安全性。结果:观察组治疗总有效率为93. 75%,对照组为77. 08%,差异有统计学意义(P <0. 05)。观察组治疗后NIHSS评分、血浆LPA水平分别为(12. 34±1. 15)分、(2. 16±0. 78)μmol/L,对照组分别为(15. 59±1. 20)分、(3. 69±1. 00)μmol/L,两组比较差异有统计学意义(P <0. 05)。与治疗前比较,两组治疗后TC、LDL-C、血清hs-CRP、IL-6、TNF-α水平均显著下降,差异均有统计学意义(P <0. 05),且观察组治疗后上述指标均显著低于对照组,差异均有统计学意义(P <0. 05)。两组均无肝肾功能异常情况和恶心、呕吐等不良反应发生。结论:阿托伐他汀钙治疗急性缺血性脑梗死效果较好,能明显改善患者神经功能缺损症状,这可能与阿托伐他汀钙调脂、降低血浆LPA水平、抑制炎性反应有关。
Objective To study the effects of atorvastatin in the treatment of acute ischemic cerebral infarction and the effect on plasma lysophosphatidic acid( LPA) level. Method 96 cases of patients with acute ischemic cerebral infarction were randomly divided into the observation group and the control group by random number table method. 48 cases in each group. The control group were given routine treatment,and the observation group were additionally treated with atorvastatin. The clinical efficacy,NIHSS scores before and after treatment,serum lipids,plasma LPA levels and serum inflammatory factors were compared between the two groups. The treatment safety was evaluated. Results The total effective rate of treatment in the observation group was 93. 75% while in the control group was 77. 08%,the difference was statistically significant( P < 0. 05). After treatment,the NIHSS score and plasma LPA level showed significant differences between the observation group than the control group[( 12. 34± 1. 15),( 2. 16 ± 0. 78) μmol/L vs( 15. 59 ± 1. 20),( 3. 69 ± 1. 00) μmol/L]( P < 0. 05). After treatment,levels of TC,LDL-C,serum hs-CRP,IL-6 and TNF-α in the two groups were significantly lower than those before treatment( P <0. 05),and the above levels were significantly lower in the observation group than the control group( P < 0. 05). There were no adverse reactions such as abnormal liver and kidney function,nausea and vomiting in the two groups. Conclusion Atorvastatin is effective in the treatment of acute ischemic cerebral infarction. It can significantly relieve symptoms of neurologic impairment,which may be related to atorvastatin regulating lipids,decreasing plasma LPA level and inhibiting inflammatory reactions.
Objective To study the effects of atorvastatin in the treatment of acute ischemic cerebral infarction and the effect on plasma lysophosphatidic acid( LPA) level. Method 96 cases of patients with acute ischemic cerebral infarction were randomly divided into the observation group and the control group by random number table method. 48 cases in each group. The control group were given routine treatment,and the observation group were additionally treated with atorvastatin. The clinical efficacy,NIHSS scores before and after treatment,serum lipids,plasma LPA levels and serum inflammatory factors were compared between the two groups. The treatment safety was evaluated. Results The total effective rate of treatment in the observation group was 93. 75% while in the control group was 77. 08%,the difference was statistically significant( P < 0. 05). After treatment,the NIHSS score and plasma LPA level showed significant differences between the observation group than the control group[( 12. 34± 1. 15),( 2. 16 ± 0. 78) μmol/L vs( 15. 59 ± 1. 20),( 3. 69 ± 1. 00) μmol/L]( P < 0. 05). After treatment,levels of TC,LDL-C,serum hs-CRP,IL-6 and TNF-α in the two groups were significantly lower than those before treatment( P <0. 05),and the above levels were significantly lower in the observation group than the control group( P < 0. 05). There were no adverse reactions such as abnormal liver and kidney function,nausea and vomiting in the two groups. Conclusion Atorvastatin is effective in the treatment of acute ischemic cerebral infarction. It can significantly relieve symptoms of neurologic impairment,which may be related to atorvastatin regulating lipids,decreasing plasma LPA level and inhibiting inflammatory reactions.
引文
[1]张淑琴,范恒,邓立军,等.阿托伐他汀钙联合阿司匹林对脑梗死患者血清Hcy、NSE、UA、hs-CRP及炎性因子水平的影响[J].海南医学院学报,2017,23(3):425.
[2]赵冬婧,汤玮,曹树军,等.阿托伐他汀对老年心肌梗死患者心室重构及血清ICAM-1、IL-6、TNF-α表达的影响[J].解放军医药杂志,2016,28(3):54.
[3]李国健,田双,李霞,等.阿托伐他汀对高脂血症合并颈动脉粥样硬化患者相关氧化应激因子水平的影响[J].医学临床研究,2016,33(1):70.
[4]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,2010,43(2):146.
[5]赵锦华,康永刚,鱼丽萍,等.强化降脂联合强化降压预防脑卒中不良事件的疗效评价[J].湖南师范大学学报(医学版),2015,12(1):108.
[6]何苏,黄莺莺,隆世宇,等.阿托伐他汀联合拜阿司匹林对缺血性脑血管病患者颈部动脉斑块及血清Ox LDL、hs-CRP的影响[J].海南医学,2016,27(1):30.
[7]焦岩,徐江涛.阿托伐他汀治疗急性缺血性卒中患者颈动脉粥样硬化斑块的临床研究[J].重庆医学,2012,41(6):550.
[8]周红霞,王兴元,范利娟,等.阿托伐他汀在急性缺血性脑卒中患者中的临床研究[J].中国临床药理学杂志,2016,32(1):72.
[9]何必华,胡东辉.阿托伐他汀对急性缺血性卒中患者血清hs-CRP水平及预后的影响[J].中国实用神经疾病杂志,2016,19(10):63.
[10]靳丽丽,朱普贤,韩雪娟,等.阿托伐他汀钙片治疗急性缺血性脑卒中的临床疗效观察[J].实用心脑肺血管病杂志,2017,25(1):117.
[11]郑侨克,熊强,罗浩,等.阿托伐他汀对急性缺血性脑卒中患者血浆溶血磷脂酸的影响[J].心血管康复医学杂志,2009,18(6):579.
[12]郑侨克,熊强,罗浩,等.阿托伐他汀对急性脑血栓患者血清溶血磷脂酸水平的影响[J].中华老年心脑血管病杂志,2009,11(3):231.
[13]陈先胜.小剂量尿激酶联合阿托伐他汀钙对急性脑梗死患者炎性反应因子水平及神经功能的影响[J].吉林医学,2017,38(9):1729.
[2]赵冬婧,汤玮,曹树军,等.阿托伐他汀对老年心肌梗死患者心室重构及血清ICAM-1、IL-6、TNF-α表达的影响[J].解放军医药杂志,2016,28(3):54.
[3]李国健,田双,李霞,等.阿托伐他汀对高脂血症合并颈动脉粥样硬化患者相关氧化应激因子水平的影响[J].医学临床研究,2016,33(1):70.
[4]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,2010,43(2):146.
[5]赵锦华,康永刚,鱼丽萍,等.强化降脂联合强化降压预防脑卒中不良事件的疗效评价[J].湖南师范大学学报(医学版),2015,12(1):108.
[6]何苏,黄莺莺,隆世宇,等.阿托伐他汀联合拜阿司匹林对缺血性脑血管病患者颈部动脉斑块及血清Ox LDL、hs-CRP的影响[J].海南医学,2016,27(1):30.
[7]焦岩,徐江涛.阿托伐他汀治疗急性缺血性卒中患者颈动脉粥样硬化斑块的临床研究[J].重庆医学,2012,41(6):550.
[8]周红霞,王兴元,范利娟,等.阿托伐他汀在急性缺血性脑卒中患者中的临床研究[J].中国临床药理学杂志,2016,32(1):72.
[9]何必华,胡东辉.阿托伐他汀对急性缺血性卒中患者血清hs-CRP水平及预后的影响[J].中国实用神经疾病杂志,2016,19(10):63.
[10]靳丽丽,朱普贤,韩雪娟,等.阿托伐他汀钙片治疗急性缺血性脑卒中的临床疗效观察[J].实用心脑肺血管病杂志,2017,25(1):117.
[11]郑侨克,熊强,罗浩,等.阿托伐他汀对急性缺血性脑卒中患者血浆溶血磷脂酸的影响[J].心血管康复医学杂志,2009,18(6):579.
[12]郑侨克,熊强,罗浩,等.阿托伐他汀对急性脑血栓患者血清溶血磷脂酸水平的影响[J].中华老年心脑血管病杂志,2009,11(3):231.
[13]陈先胜.小剂量尿激酶联合阿托伐他汀钙对急性脑梗死患者炎性反应因子水平及神经功能的影响[J].吉林医学,2017,38(9):1729.