摘要
目的探讨匹伐他汀钙对症状性动脉粥样硬化颅内动脉狭窄患者粥样斑块稳定性、脑血流动力学及脑血管事件再发的影响。方法选择2016年6月-2017年6月某院收治的70例sICAS患者为研究对象,随机分为观察组和对照组各35例,对照组患者给予抗血小板聚集、抗凝等常规治疗以及控制血压、血糖等对症治疗,观察组在对照组治疗基础上给予匹伐他汀钙口服治疗。观察并记录治疗前及治疗6个月后患者动脉粥样斑块成分比例、斑块纤维帽厚度、斑块体积、颅内血流动力学指标变化以及脑血管事件再发情况,进行对比分析。结果治疗6个月后复查,两组患者颅内动脉狭窄率、IMT、坏死核心比例、纤维比例及斑块纤维帽厚度均较治疗前得到了不同程度的改善,观察组患者颅内动脉狭窄率、IMT及坏死核心比例均明显低于对照组,而纤维比例、斑块纤维帽厚度均明显高于对照组,差异均有统计学意义(P<0.05)。两组患者颅内动脉狭窄段Vs、Vd、Vm水平均较治疗前明显降低,PI值明显升高,且观察组Vs、Vd、Vm水平明显低于对照组,PI值明显高于对照组,差异均有统计学意义(P<0.05)。6个月随访期间,两组患者均未出现肝功能异常现象,而观察组TIA或脑卒中发生率低于对照组,但差异无统计学意义(P>0.05)。结论匹伐他汀钙治疗能明显提高sICAS患者粥样斑块稳定性,改善颅内动脉狭窄段的血流灌注,同时能在一定程度上降低短期内脑血管事件再发率。
Objectives To explore the effects of pivastatin calcium on the stability of atherosclerosis, cerebral hemodynamics and recurrence of cerebral vascular events in patients with intracranial arterial stenosis. Methods in June 2016-June 2017 of 70 sICAS patients admitted in a hospital as the research object, were randomly divided into observation group and control group, 35 cases in the control group patients give antiplatelet aggregation, conventional treatments such as anticoagulant, and control of blood pressure, blood sugar, such as symptomatic treatment, observation group was treated in the control group on the basis of given horse cutting statin oral calcium treatment. The composition proportion of atherosclerotic plaque, the thickness of plaque fiber cap, plaque volume, the change of intracranial hemodynamic index and the recurrence of cerebral vascular events were observed and recorded before and after 6 months of treatment, and the comparative analysis was conducted. Results 6 months after treatment, the review of the two groups of patients with intracranial artery stenosis rate, IMT, necrotic core rate, fiber ratio and the thickness of the fibrous cap patch before the treatment, are improved to varying degrees, observation group of patients with intracranial artery stenosis rate, IMT and necrotic core rate were significantly lower than the control group, and fiber proportion, plaque thickness were significantly higher than that of control group, fibrous cap were statistically significant differences（P〈0.05）. The level of Vs, Vd and Vm in the intracranial stenosis segment of patients in both groups were significantly lower than that before treatment, and the PI value was significantly increased. In addition, the level of Vs, Vd and Vm in the observation group was significantly lower than that in the control group, and the PI value was significantly higher than that in the control group, with statistically significant differences（P〈0.05）. During the 6-month follow-up, no abnormal liver function occurred in both groups, while the incidence of TIA or stroke in the observation group was lower than that in the control group, but the difference was not statistically significant（P〈0.05）. Conclusions Pivastatin calcium therapy could significantly improve the stability of atherosclerotic plaques in sICAS patients, improve the blood perfusion of intracranial arterial stenosis and reduce the recurrence rate of cerebral vascular events to some extent.
作者
卢波
王晓静
王沙沙
Lu Bo;Wang Xiaojing;Wang Shasha(The Second Department of Neurology,The Second Central Hospital of Baoding City in Hebei Province,Zhuozhou 072750,China)
出处
《中国病案》
2018年第11期93-96,共4页
Chinese Medical Record
基金
河北省保定市科技支撑计划项目(17ZF204)
关键词
匹伐他汀钙
动脉粥样硬化
颅内动脉狭窄
血流动力学
脑血管事件
Pivastatin calcium
Atherosclerosis
Intracranial artery stenosis
Hemodynamics
Cerebral vascular event
