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不同劑量瑞舒伐他汀治療急性腦梗死的臨床觀察

發(fā)布時(shí)間:2018-07-23 20:45
【摘要】:目的:觀察不同劑量瑞舒伐他汀在急性腦梗死患者治療中的有效性及安全性。方法:選取2014年1月-2015年12月濰坊市益都中心醫(yī)院收治的急性腦梗死患者120例,按照入院先后順序分為觀察組和對(duì)照組,各60例。兩組患者均給予舒血寧注射液10 m L,iv,每日1~2次(或者20 m L加至5%葡萄糖注射液250~500 m L中,ivgtt,qd)+阿司匹林腸溶片0.1 g,po,qd等基礎(chǔ)治療;對(duì)照組和觀察組在基礎(chǔ)治療方案上分別給予瑞舒伐他汀鈣片10 mg和20 mg,po,qd(晚餐后)。兩組患者均治療30 d。觀察兩組患者治療前后血清炎癥因子[超敏C反應(yīng)蛋白(hs-CRP)、腫瘤壞死因子α(TNF-α)、白細(xì)胞介素(IL)-6]和血脂指標(biāo)[總膽固醇(TC)、三酰甘油(TG)和低密度脂蛋白膽固醇(LDL-C)]水平、神經(jīng)功能和日常生活能力評(píng)分,以及臨床療效和不良反應(yīng)發(fā)生情況。結(jié)果:治療前,兩組患者h(yuǎn)s-CRP、TNF-α、IL-6、TC、TG、LDL-C水平以及美國(guó)國(guó)立衛(wèi)生院腦卒中量表(NIHSS)評(píng)分和日常生活活動(dòng)能力量表(BI)評(píng)分等比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。治療后,兩組患者h(yuǎn)s-CRP、TNF-α、IL-6、TC、TG、LDL-C水平和NIHSS評(píng)分均顯著降低,BI評(píng)分顯著升高,且觀察組顯著優(yōu)于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組患者總有效率(93.33%)顯著高于對(duì)照組(86.67%),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組患者的不良反應(yīng)發(fā)生率(23.33%)顯著高于對(duì)照組(6.67%),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:瑞舒伐他汀可顯著降低急性腦梗死患者的炎癥反應(yīng)和血脂水平,抑制動(dòng)脈粥樣硬化斑塊的形成,改善患者預(yù)后。較大劑量的瑞舒伐他汀治療急性腦梗死療效更好,可明顯改善患者的神經(jīng)功能缺損癥狀,并提高其日常生活能力。
[Abstract]:Objective: to observe the efficacy and safety of different doses of rosuvastatin in the treatment of acute cerebral infarction. Methods: 120 patients with acute cerebral infarction treated in Yidu Central Hospital of Weifang from January 2014 to December 2015 were divided into observation group (n = 60) and control group (n = 60). The patients in both groups were given 10 mL of Shuxuening injection iv twice a day (or 20 mL added to 5% glucose injection 250 ml / 500 mL) aspirin enteric-coated tablets 0.1 g / kg poqd, and so on. The control group and the observation group were treated with rosuvastatin calcium tablets 10 mg and 20 mg / kg poqd respectively (after dinner). Both groups were treated for 30 days. The levels of serum inflammatory factor (hs-CRP), tumor necrosis factor- 偽 (TNF- 偽), interleukin-6 (IL) -6) and serum lipids [total cholesterol (TC), triacylglycerol (TG) and low density lipoprotein cholesterol (LDL-C)] were measured before and after treatment. Neurological function and ADL scores, as well as clinical efficacy and adverse reactions. Results: before treatment, there was no significant difference between the two groups in the levels of hs-CRP TNF- 偽 IL-6, TGN LDL-C, the (NIHSS) score of stroke scale and the activity of daily living scale (BI) in the National Institutes of Health of the United States. There was no significant difference between the two groups (P0.05). After treatment, the level of TGG LDL-C and the NIHSS score of hs-CRPnTNF- 偽 TNF- 偽 were significantly decreased, and the observation group was significantly better than the control group, the difference was statistically significant (P0.05). The total effective rate of the observation group (93.33%) was significantly higher than that of the control group (86.67%), the difference was statistically significant (P0.05). The incidence of adverse reactions in the observation group (23.33%) was significantly higher than that in the control group (6.67%), and the difference was statistically significant (P0.05). Conclusion: rosuvastatin can significantly reduce the inflammatory response and blood lipid level in patients with acute cerebral infarction, inhibit the formation of atherosclerotic plaques, and improve the prognosis of patients with acute cerebral infarction. A higher dose of Risuvastatin was more effective in the treatment of acute cerebral infarction, which could significantly improve the symptoms of neurological deficit and improve the ability of daily living.
【作者單位】: 濰坊市益都中心醫(yī)院神經(jīng)內(nèi)一科;青州市人民醫(yī)院神經(jīng)外一科;
【基金】:濰坊市科學(xué)技術(shù)發(fā)展計(jì)劃項(xiàng)目(No.2015ws109)
【分類(lèi)號(hào)】:R743.33

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