摘要
目的探讨阿托伐他汀联合氯吡格雷对恢复期脑梗死患者颈动脉粥样斑块的影响。方法选取恢复期脑梗死患者92例,随机分为观察组与对照组,每组46例。对照组给予基础治疗与康复措施,药物选用氯吡格雷;观察组在对照组的基础上增加阿托伐他汀,两组均治疗6个月。应用颈动脉超声测定治疗前后颈动脉管腔直径(CCAD)、斑块面积及内中膜厚度(IMT),观察血液流变学指标及1年内复发率。结果治疗前两组患者斑块面积、IMT、CCAD及血液流变学指标水平比较,差异均无统计学意义(P>0.05);治疗6个月后,两组患者颈动脉粥样斑块出现一定程度的面积减少、IMT变薄、CCAD增加,血流动力学改善(对照组血小板聚集率、纤维蛋白原除外),差异均具有统计学意义(P<0.05或P<0.01);且观察组斑块面积、IMT、CCAD及血流动力学改善情况均优于对照组(P<0.05)。观察组与对照组斑块治疗总有效率分别为86.96%、60.87%,1年内复发率分别为6.98%、15.56%,差异均具有统计学意义(P<0.05)。结论阿托伐他汀联合氯吡格雷对恢复期脑梗死患者颈动脉粥样斑块具有较好的稳定或逆转作用,同时改善了血流动力学,降低了近期复发率,可作为恢复期脑梗死患者的推荐治疗方案。
Objective To explore the influence of carotid atherosclerotic plaques in patients with cerebral infarction receiving atorvastatin and elopidogrel. Methods 92 patients with cerebral infarction in recovery period were seleetedin this study.The patients were randomly and equally divided into observation group and control group.Patients in the control group were given with clopidogrel based on routine treatment and rehabilitation measures.Patients in the observation group were given with atorvastatin and clopidogrel.All the patients were treated for 6 months.Before and after the treatment＇, carotid artery lumen diameter （CCAD）, the areas of plaque and intima-media thickness （IMT） were tested by carotid artery ultrasound. Hemorheology indexes and recurrence rate within 1 year were also monitored. Results There were no statistical difference between the two groups on plaque area, IMT, CCAD and hemorheology indexes before the treatment （P〉0.05）. After six months of treatment, the values of plaque area and IMT were decreased, and CCAD was increased. Hemorheology indexes （except for platelet aggregation rate and fibrinogen incontrol group） in the control （P〈0.05） and observation group （P〈0.01） were improved after the treatment. The degree of improvement on plaque area, IMT, CCAD and hemorheology indexes in the observation group was superior than the control group （P〈0.05）. Total effective rate on plaque therapy in the observation group and control group was 86.96% and 60.87% ,respectively. 1 year recurrence ratein the observation group （P〈0.05） and control group （P〈0.01） was 6.98% and 15.56%,respectively. Conclusions Combined atorvastatin and clopidogrel can stabilize/improve the patients with cerebral infarction during therecovery period.The treatment can also improve hemorheology indexes and reduce the recurrence rate.
出处
《热带医学杂志》
CAS
2014年第3期339-341,379,共4页
Journal of Tropical Medicine
关键词
脑梗死
恢复期
氯吡格雷
阿托伐他汀
内中膜厚度
cerebral infarction
recovery period
clopidogrel
atorvastatin
intima-media thickness
