摘要
目的 探讨不同剂量叶酸联合阿托伐他汀治疗脑梗死合并高血压患者的预后。方法 选取2021年1月至2022年12月首都医科大学附属北京世纪坛医院收治的脑梗死合并高血压患者159例,采用随机数字表法分为3组,各53例。对照组口服阿托伐他汀钙片治疗,小剂量组加用0.8mg·d^(-1)叶酸片治疗,正常剂量组在对照组基础上加用5mg·d^(-1)叶酸片。观察三组临床治疗效果,对比各组治疗前后神经功能缺损评分(NIHSS)、Barthel指数(BI)、血压以及血管内皮功能指标变化。结果 小剂量组及正常剂量组临床总有效率均明显高于对照组(P<0.05),小剂量组与正常剂量组总有效率相当(P>0.05)。治疗后,小剂量组和正常剂量组患者NIHSS评分及血清内皮素-1 (ET-1)水平低于对照组,BI评分、血压及血清一氧化氮(NO)、血管内皮生长因子(VEGF)水平高于对照组(均P<0.05)。小剂量组与正常剂量组治疗后NIHSS评分、BI评分、血压及血管内皮功能指标差异无统计学意义(P>0.05)。小剂量组与正常剂量组复发率相当(P> 0.05),均小于对照组(P<0.05);但小剂量组患者不良反应发生率明显低于正常剂量组(P<0.05)。结论 叶酸联合阿托伐他汀治疗脑梗死合并高血压疗效显著,能够有效改善血压及血管内皮功能,降低脑梗死复发率,其中小剂量叶酸治疗效果与常规剂量相当,但安全性更高。
Objective To investigate the prognosis of different doses of folic acid combined with atorvastatin in the treatment of cerebral infarction complicated with hypertension.Methods A total of 159 patients with cerebral infarction complicated with hypertension admitted to Beijing Shijitan hospital affiliated to capital medical university from January 2021 to December 2022 were selected and divided into 3 groups by random number table method,with53 cases in each group.The control group was treated with atorvastatin calcium tablets,the low-dose group was treated with 0.8mg·d^(-1)folic acid tablets,the normal dose group was treated with 5mg·d^(-1)folic acid tablets on the basis of the control group.The clinical effects of the three groups were observed,and the changes of neurological deficit score(NIHSS),Barthel index(BI),blood pressure and vascular endothelial function indexes were compared before and after treatment in each group.Results The total effective rate of the small dose group and the normal dose group was significantly higher than that of the control group(P<0.05),and the total effective rate of the small dose group and the normal dose group was similar(P>0.05).After treatment,NHSS score and serum endothelin-1(ET-1)levels in lowdose and normal-dose groups were lower than those in control group,while BI score,blood pressure,serum nitric oxide(NO)and vascular endothelial growth factor(VEGF)levels were higher than those in control group(~(all)P<0.05).There were no significant differences in NIHSS score,BI score,blood pressure and vascular endothelial function between lowdose group and normal dose group(P>0.05).The recurrence rate of small dose group and normal dose group was similar(P>0.05),but lower than that of control group(P<0.05).However,the incidence of adverse reactions in low-dose group was significantly lower than that in normal dose group(P<0.05).Conclusion Folic acid combined with atorvastatin is effective in the treatment of cerebral infarction complicated with hypertension,which can effectively im
作者
郑雪
司童
Zheng Xue;Si Tong(Department of Neurology and Psychiatry,Bejing Shijitan Hospital Affiliated to Capital Medical University,Beijing 100038,China)
出处
《脑与神经疾病杂志》
CAS
2024年第3期162-166,共5页
Journal of Brain and Nervous Diseases
基金
北京市科技计划课题(Z19110011718139)。
关键词
脑梗死
高血压
叶酸剂量
阿托伐他汀
内皮功能
Cerebral infarction
Hypertension
Folic acid dose
Atorvastatin
Endothelial function
