摘要
目的分析比较不同剂量普伐他汀对急性脑梗死(ACI)合并高脂血症患者血脂水平及神经功能缺损的影响.方法选取2016年10月至2017年11月运城市中心医院急诊科收治的84例ACI合并高脂血症患者,采用随机数表法将其随机分为常规剂量组与双倍剂量组,每组42例.常规剂量组男27例,女15例,年龄(50.74±9.08)岁,年龄范围为20~65岁.双倍剂量组男29例,女13例,年龄(51.54±9.13)岁,年龄范围为20~65岁.两组患者均给予降颅压、平稳血糖等常规对症治疗,并予以舒血宁注射液及阿司匹林肠溶片抗血小板聚集治疗.常规剂量组在此基础上予以普伐他汀20 mg/d口服治疗,双倍剂量组则予以普伐他汀40 mg/d口服治疗.比较两组治疗前及治疗3个月后脂代谢指标[甘油三酯、总胆固醇、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、炎症反应指标[同型半胱氨酸(Hcy)、胱抑素C(CysC)]、载脂蛋白B/AⅠ(ApoB/ApoAⅠ)水平、颈动脉斑块情况[颈动脉内中膜厚度(IMT)]、神经功能缺损程度[美国国立卫生研究院卒中量表(NIHSS)]差异,并记录两组治疗期间不良反应差异.结果治疗3个月后,双倍剂量组血清甘油三酯[(1.52±0.30)mmol/L]、总胆固醇[(4.25±0.81)mmol/L]、LDL-C[(2.41±0.45)mmol/L]水平均较常规剂量组[(1.68±0.32)mmol/L、(4.67±0.83)mmol/L、(2.65±0.52)mmol/L]降低,HDL-C[(1.33±0.22)mmol/L]水平则较常规剂量组[(1.23±0.21)mmol/L]升高,差异均有统计学意义(P<0.05).双倍剂量组Hcy[(14.16±2.57)μmol/L]、CysC[(0.72±0.14)mg/ml]、ApoB/ApoAⅠ[(0.82±0.16)μg/L]、IMT[(1.30±0.20)mm]、NIHSS[(8.49±1.78)分]较常规剂量组[(15.78±2.69)μmol/L、(0.79±0.15)mg/ml、(0.91±0.17)μg/L、(1.41±0.28)mm、(9.51±1.89)分]降低,差异均有统计学意义(P<0.05).常规剂量组不良反应发生率[11.9%(5/42)]与双倍剂量组[19.0%(8/42)]比较,差异无统计学意义(P>0.05).结论较高剂量(40 mg/d)的普伐他汀对ACI合并高脂血症患�
Objective To analyze and compare the effects of different doses of pravastatin on blood lipid level and neurological deficits in patients with acute cerebral infarction(ACI)complicated with hyperlipidemia.Methods The 84 ACI patients with hyperlipidemia admitted from October 2016 to Novem-ber 2017 were selected.They were randomly divided into routine dose group and double dose group by ran-dom number table method,with 42 patients in each group.In the conventional dose group,there were 27 males and 15 females,aged(50.74±9.08)years,ranging from 20 to 65 years.In the double-dose group,there were 29 males and 13 females,aged(51.54±9.13)years,ranging from 20 to 65 years.Patients in both groups were given conventional symptomatic treatment such as lowering cranial pressure and stabilizing blood glucose,and Shuxuening injection and aspirin enteric-coated tablet were given as anti-platelet aggre-gation therapy.The conventional dose group received 20 mg/d oral treatment with pravastatin,and the doub-le dose group received 40 mg/d oral treatment with pravastatin.Compare two groups before and after 3 months treatment lipid metabolism index[triglyceride,total cholesterol,high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)],inflammation index[homocysteine(Hcy),urinary inhibition C(CysC)],apolipoprotein B/AⅠ(ApoB/ApoAⅠ)levels and carotid plaques[carotid intima-media thickness(IMT)],nerve function defect degree of[the United States national institutes of health stroke scale(NIHSS)]differences,and record adverse reactions during treatment similar between the two groups.Results After 3 months of treatment,serum triglyceride[(1.52±0.30)mmol/L],total cholester-ol[(4.25±0.81)mmol/L],LDL-C[(2.41±0.45)mmol/L]levels in the double-dose group were all lower than those in the conventional dose group[(1.68±0.32)mmol/L,(4.67±0.83)mmol/L,(2.65±0.52)mmol/L].HDL-C[(1.33±0.22)mmol/L]level was higher than that of the conventional dose group[(1.23±0.21)mmol/L]level,and the difference was statistical
作者
杜运宏
李丽娟
王武
马敏
Du Yunhong;Li Lijuan;Wang Wu;Ma Min(Department of Emergency,Yuncheng Central Hospital,Yuncheng 044000,China;Department of Administration Office,Yuncheng Tongde Hospital,Yuncheng 044000,China)
出处
《中国临床实用医学》
2019年第6期13-17,共5页
China Clinical Practical Medicine
关键词
急性脑梗死
高脂血症
普伐他汀
血脂水平
神经功能缺损
Acute cerebral infarction
Hyperlipidemia Pravastatin
Blood lipid level
Neurological deficits
