摘要
目的探讨普罗布考联合匹伐他汀治疗老年高血压合并脑梗死恢复期的临床疗效以及其对血脂和血清氧化型低密度脂蛋白自身抗体(ox-LDL-Ab)、Klotho蛋白、基质金属蛋白酶-9(MMP-9)及超敏C反应蛋白(hs-CRP)水平的影响。方法选取2020-06—2021-06河北北方学院附属第一医院收治的100例老年高血压合并脑梗死恢复期患者为研究对象,观察组50例,对照组50例。其中对照组口服匹伐他汀钙片治疗,观察组在此基础上口服普罗布考片治疗。所有对象均连续治疗6个月后观察其临床疗效。比较治疗前后2组相关量表[12项世界卫生组织生存质量老年模块量表简表(WHOQOL-OLD-12)和美国国立卫生研究院卒中量表(NIHSS)]评分、血脂水平及血清ox-LDL-Ab、Klotho蛋白、MMP-9和hs-CRP水平。并统计2组不良反应情况。结果观察组总有效率[88.0%(44/50)]显著高于对照组[72.0%(36/50),P<0.05]。观察组治疗前WHOQOL-OLD-12评分为(65.42±12.61)分,治疗后为(77.85±13.06)分,治疗前NIHSS评分为(12.37±3.15)分,治疗后为(5.18±1.53)分,对照组分别为(63.29±13.20)分、(70.57±15.38)分、(11.89±2.92)分、(6.26±1.84)分;2组患者治疗后WHOQOL-OLD-12评分均显著高于本组治疗前(P<0.05),NIHSS评分则均显著下降(P<0.05)。且治疗后,观察组对WHOQOL-OLD-12评分较对照组显著提高,NIHSS评分较对照组显著降低(P<0.05)。2组患者治疗后血清TC、TG、LDL-C浓度均较治疗前显著降低(P<0.05),血清HDL-C含量则均显著上升(P<0.05)。治疗后观察组血清TC、TG、LDL-C水平均较对照组显著降低,血清HDL-C水平较对照组显著提高(P<0.05)。与本组治疗前对比,2组治疗后血清ox-LDL-Ab、MMP-9及hs-CRP水平均显著下降(P<0.05),血清Klotho蛋白水平均显著升高(P<0.05)。治疗后观察组血清ox-LDL-Ab、MMP-9及hs-CRP水平均显著低于同期对照组(P<0.05),血清Klotho蛋白水平显著升高(P<0.05)。观察组不良反应发生率[10.0%(5/50)]与对照组[6.0%(3/50)]相比,差异无统计学意义(P>0.05)。结论普罗布考联合匹伐他汀治疗老年高血压合并脑梗死恢复期的总体疗效良好,可安全有效地促进患者神经功能的恢复,提高其生存质量,该联合治疗方案的作用机制可能是通过显著改善血脂水平及下调血清ox-LDL-Ab、MMP-9、hs-CRP表达水平和上调血清Klotho蛋白表达水平的途径来实现的。
Objective To investigate the clinical efficacy of probucol combined with pivastatin in the treatment of elderly hypertension complicated with cerebral infarction in convalescent stage,and the effects of probucol combined with pivastatin on serum lipid and levels of ox-LDL-Ab,Klotho protein,matrix metalloproteinase-9(MMP-9)and hs-CRP.Methods From June 2020 to June 2021,100 elderly patients with hypertension complicated with cerebral infarction in convalescent stage admitted to the First Affiliated Hospital of Hebei North University were selected as the research objects.There were 50 cases in the observation group and 50 cases in the control group.The control group was treated with pitavastatin calcium tablet,and the observation group was treated with probucol tablet on this basis.All subjects were continuously treated for 6 months and their clinical efficacy was observed.The scores including the World Health Organization quality of life elderly module scale(WHOQOL-OLD-12)and the National Institutes of Health stroke scale(NIHSS),blood lipid levels,and serum ox-LDL-Ab,Klotho protein,MMP-9,and hs-CRP levels of two sets of related scales before and after treatment were compared,and the adverse reactions of two groups were analyzed.Results The total effective rate of the observation group[88.0%(44/50)]was significantly higher than that of the control group[72.0%(36/50),P<0.05].In the observation group,WHOQOL-OLD-12 score was(65.42±12.61)points before treatment,(77.85±13.06)points after treatment,NIHSS score was(12.37±3.15)points before treatment,and(5.18±1.53)points after treatment.The control group was(63.29±13.20)points,(70.57±15.38)points,(11.89±2.92)points and(6.26±1.84)points,respectively.After treatment,WHOQOL-OLD-12 scores in two groups were significantly higher than before treatment(P<0.05),and NIHSS scores were significantly decreased(P<0.05).After treatment,the WHOQOL-OLD-12 score of the observation group was significantly higher than that of the control group,and the NIHSS score was significantly lower than that of the control group(P<0.05).After treatment,serum TC,TG and LDL-C concentrations in two groups were significantly decreased compared with before treatment(P<0.05),while serum HDL-C content was significantly increased(P<0.05).After treatment,the levels of TC,TG and LDL-C in serum of observation group were significantly decreased compared with control group,and the level of HDL-C in serum was significantly increased compared with control group(P<0.05).Compared with the group before treatment,the serum levels of ox-LDL-Ab,MMP-9 and hs-CRP were significantly decreased(P<0.05),and the serum Klotho protein levels were significantly increased(P<0.05)in both groups after treatment.After treatment,the levels of ox-LDL-Ab,MMP-9 and hs-CRP in the observation group were significantly lower than those in the control group(P<0.05),and the level of Klotho protein in the serum was significantly increased(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group[10.0%(5/50)]and the control group[6.0%(3/50)](P>0.05).Conclusion Probucol combined with pitavastatin has a good overall effect in the treatment of senile hypertension complicated with cerebral infarction during the recovery period.It could safely and effectively promote the recovery of patients’neurological function and improve their quality of life.The mechanism of action of the combined treatment plan may be realized through significantly improving blood lipids level,down-regulating the expression levels of serum ox-LDL-Ab,MMP-9,hs-CRP and up-z-regulating the expression level of serum Klotho protein.
作者
黄攀登
董利平
郭美丹
刘杨杨
席晓霞
高云鹰
吴佳宏
崔玉环
HUANG Pandeng;DONG Liping;GUO Meidan;LIU Yangyang;XI Xiaoxia;GAO Yunying;WU Jiahong;CUI Yuhuan(The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)
出处
《中国实用神经疾病杂志》
2023年第11期1378-1383,共6页
Chinese Journal of Practical Nervous Diseases
基金
河北省医学科学研究重点课题计划项目(编号:20200551)
张家口市科技攻关计划项目(编号:2021045D)。
