摘要
目的探讨不同剂量阿托伐他汀联合阿司匹林对急性脑梗死患者脑血流指标以及颈动脉粥样斑块的影响。方法将2011年1月至2014年1月江油市中医医院收治的180例急性脑梗死患者按随机数字表法分为A、B、C三组,各组常规口服阿司匹林100 mg/d,在此基础上,各组均每日口服1次阿托伐他汀,A组10 mg/d,B组20 mg/d,C组40 mg/d。比较各组治疗前后颈动脉粥样斑块面积与厚度变化以及脑血流指标。结果 B、C两组治疗后颈动脉粥样硬化斑块面积[(0.50±0.14)mm2比(0.64±0.21)mm2、(0.40±0.11)mm2比(0.65±0.19)mm2]、颈动脉内膜-中层厚度(IMT)[(1.41±0.16)mm比(1.63±0.33)mm、(1.23±0.12)mm比(1.62±0.33)mm]较治疗前均显著降低,差异有统计学意义(P<0.05),且治疗后C组斑块面积与IMT显著低于B组,差异有统计学意义(P<0.05),治疗后A组、B组、C组平均血流量、平均血流速度较治疗前显著增加(P<0.05),外周阻力与脑血管床特性阻抗较治疗前显著降低,差异有统计学意义(P<0.05),但各组组间脑循环动力学参数差异无统计学意义(P>0.05);治疗后各组红细胞刚性指数、纤维蛋白原、全血黏度低切、血浆黏度均较治疗前显著降低(P<0.05),治疗后三组间红细胞刚性指数、纤维蛋白原、全血黏度低切、血浆黏度比较差异无统计学意义(P>0.05)。结论高剂量的阿托伐他汀可有效缩小急性脑梗死患者颈动脉粥样硬化斑块面积,降低脑卒中风险,而脑梗死患者脑循环动力学与脑血液流变学的改变可能与阿托伐他汀的剂量无关。
Objective To investigate the influence of different doses of atorvastatin on carotid atherosclerosis and cerebral blood flow indicators in patients with acute cerebral infarction. Methods Total of 180 acute cerebral infarction patients in Jiangyou Chinese Medicine Hospital were randomly divided into group A,group B,group C according to random number table method,all of the three groups received routine treatment of aspirin,oral 100 mg / d. On the basis of the routine treatment,group A was given atorvastatin 10 mg / d,group B was given atorvastatin 20 mg / d,group C was given atorvastatin 40 mg / d,oral administration. The cerebral blood flow indicators,carotid plaque area and thickness of the three groups were observed and compared before and after treatment. Results The atherosclerotic plaque area[（ 0. 50 ± 0. 14） mm2vs（ 0. 64 ±0. 21） mm2,（ 0. 40 ± 0. 11） mm2vs（ 0. 65 ± 0. 19） mm2] and IMT [（ 1. 41 ± 0. 16） mm vs（ 1. 63 ±0. 33） mm,（ 1. 23 ± 0. 12） mm vs（ 1. 62 ± 0. 33） mm] of group B and group C were significantly reduced compared with before treatment,the differences were statistically significant（ P 〈0. 05）,plaque area and IMT of group C were significantly lower than group A,B（ P 〈0. 05）; mean Q and mean V of each group increased compared with before treatment（ P 〈0. 05）,R and Zc significantly reduced（ P 〈0. 05）,but there was no significant difference of hemodynamics parameters among groups（ P 〉0. 05）; erythrocyte rigidity index,fibrinogen,whole blood viscosity,plasma viscosity in each group after treatment were significantly lower than before treatment（ P 〈0. 05）,there were no significant difference among the groups（ P 〉0. 05）.Conclusion High doses of atorvastatin in patients with acute cerebral infarction can effectively reduce carotid atherosclerotic plaque area and the risk of stroke,while changes of the brain dynamics and hemorrheology may be independent from the dose of atorvastatin.
出处
《医学综述》
2016年第6期1201-1204,共4页
Medical Recapitulate
