不同剂量瑞舒伐他汀治疗急性脑梗死的临床观察

发布时间：2018-07-23 20:45

【摘要】：目的:观察不同剂量瑞舒伐他汀在急性脑梗死患者治疗中的有效性及安全性。方法:选取2014年1月-2015年12月潍坊市益都中心医院收治的急性脑梗死患者120例,按照入院先后顺序分为观察组和对照组,各60例。两组患者均给予舒血宁注射液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)+阿司匹林肠溶片0.1 g,po,qd等基础治疗;对照组和观察组在基础治疗方案上分别给予瑞舒伐他汀钙片10 mg和20 mg,po,qd(晚餐后)。两组患者均治疗30 d。观察两组患者治疗前后血清炎症因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6]和血脂指标[总胆固醇(TC)、三酰甘油(TG)和低密度脂蛋白胆固醇(LDL-C)]水平、神经功能和日常生活能力评分,以及临床疗效和不良反应发生情况。结果:治疗前,两组患者hs-CRP、TNF-α、IL-6、TC、TG、LDL-C水平以及美国国立卫生院脑卒中量表(NIHSS)评分和日常生活活动能力量表(BI)评分等比较,差异均无统计学意义(P0.05)。治疗后,两组患者hs-CRP、TNF-α、IL-6、TC、TG、LDL-C水平和NIHSS评分均显著降低,BI评分显著升高,且观察组显著优于对照组,差异均有统计学意义(P0.05)。观察组患者总有效率(93.33%)显著高于对照组(86.67%),差异有统计学意义(P0.05)。观察组患者的不良反应发生率(23.33%)显著高于对照组(6.67%),差异有统计学意义(P0.05)。结论:瑞舒伐他汀可显著降低急性脑梗死患者的炎症反应和血脂水平,抑制动脉粥样硬化斑块的形成,改善患者预后。较大剂量的瑞舒伐他汀治疗急性脑梗死疗效更好,可明显改善患者的神经功能缺损症状,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- 伪 (TNF- 伪), 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- 伪 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- 伪 TNF- 伪 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.
【作者单位】：潍坊市益都中心医院神经内一科;青州市人民医院神经外一科;
【基金】：潍坊市科学技术发展计划项目(No.2015ws109)
【分类号】：R743.33

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