摘要
目的探讨大剂量阿托伐他汀联合双联抗血小板对急性脑梗死患者补体激活3a受体1(C3aR1)及颈动脉斑块的影响。方法回顾性分析保定市第一中心医院诊治的129例急性脑梗死患者的一般资料,分为大剂量组65例,常规剂量组64例。常规剂量组接受常规剂量阿托伐他汀联合双联抗血小板治疗,大剂量组接受大剂量阿托伐他汀联合双联抗血小板治疗,比较2组患者颈动脉斑块面积、颈动脉内膜中层厚度(IMT)、NIHSS评分、生活自理量表(ADL)评分、超敏C反应蛋白(hs-CRP)、血脂、C3aR1及不良反应发生率。结果治疗后大剂量组甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)水平较常规剂量组低,高密度脂蛋白胆固醇(HDL-C)水平较常规剂量组高(P<0.05)。治疗后,大剂量组hs-CRP、C3aR1水平较常规剂量组低(P<0.05),颈动脉斑块面积较常规剂量组小,IMT较常规剂量组薄(P<0.05)。治疗后,大剂量组NIHSS评分较常规剂量组低,ADL评分较常规剂量组高(P<0.05)。2组治疗期间不良反应发生率比较(13.85%比9.38%)差异无统计学意义(χ^(2)=0.627,P=0.428)。结论大剂量阿托伐他汀联合双联抗血小板治疗可改善急性脑梗死患者的血脂水平,减轻炎症反应和神经损伤,降低C3aR1水平,减小颈动脉斑块面积,疗效确切,安全性高。
Objective To investigate the effect of high-dose atorvastatin combined with dual antiplatelet on complement activated 3a receptor 1(C3aR1)and carotid plaque in patients with acute cerebral infarction.Methods A retrospective analysis was conducted on the general data of 129 patients with acute cerebral infarction treated in the First Central Hospital of Baoding.According to different medication regimens,they were divided into the high-dose group of 65 cases and the conventional dose group of 64 cases.The conventional dose group received conventional dose atorvastatin combined with dual antiplatelet therapy,and the high-dose group received high-dose atorvastatin combined with dual antiplatelet therapy.The area of carotid plaques,carotid intima-media thickness(IMT),National Institutes of Health stroke scale(NIHSS)score,activities of daily living(ADL)score,high-sensitivity C-reactive protein(hs-CRP)level,blood lipid level,C3aR1 level,and incidence of adverse reactions between the two groups were compared.Results After treatment,the high-dose group had lower levels of triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),and total cholesterol(TC)compared to the conventional dose group,while high-density lipoprotein cholesterol(HDL-C)was higher than that of the conventional dose group(P<0.05).After treatment,the levels of hs-CRP and C3aR1 in the high-dose group were lower than those in the conventional dose group(P<0.05),the area of carotid artery plaques was smaller than that of the conventional dose group,and the IMT was thinner than that of the conventional dose group(P<0.05).After treatment,the high-dose group had lower NIHSS scores and higher ADL scores than the conventional dose group(P<0.05).The incidence of adverse reactions in the high-dose group was 13.85%,and there was no significant difference compared to the conventional dose group of 9.38%(χ^(2)=0.627,P=0.428).Conclusion High dose atorvastatin combined with dual antiplatelet therapy can improve the blood lipid level of patients with acute cerebral infarction,reduce inflammatory reaction and nerve damage,and the level of C3aR1 and the area of carotid plaque.It is effective and safe.
作者
康丽娟
李盼
耿丽颖
孟琦
李志安
段雪娇
郭艳敏
KANG Lijuan;LI Pan;GENG Liying;MENG Qi;LI Zhian;DUAN Xuejiao;GUO Yanmin(Baoding First Central Hospital,Baoding 071000,China)
出处
《中国实用神经疾病杂志》
2024年第7期843-848,共6页
Chinese Journal of Practical Nervous Diseases
基金
保定市科技计划项目(编号:2241ZF036)。
