瑞舒伐他汀联合依折麦布治疗高龄颈动脉粥样硬化斑块患者的临床研究

发布时间：2018-06-27 01:51

  本文选题：瑞舒伐他汀 + 依折麦布　； 参考：《新乡医学院》2014年硕士论文

【摘要】：背景颈动脉粥样硬化是缺血性脑血管病的危险因素之一,注重对颈动脉粥样硬化斑块的研究则对脑卒中的发生、发展及防治有深远的意义。他汀类药物联合依折麦布对于高龄颈动脉粥样硬化斑块患者,不仅能获得斑块的逆转、降低缺血性脑卒中发生率的近期获益,更有生存期延长、生存质量提高的远期获益。目的收集颈动脉粥样硬化斑块患者的临床资料,通过随诊观察,临床评估瑞舒伐他汀联合依折麦布治疗及单纯瑞舒伐他汀治疗对高龄颈动脉粥样硬化斑块患者的疗效差异,与导临床对高龄颈动脉粥样硬化斑块患者的临床用药。方法收集2012年3月——2013年12月我院143例经颈动脉彩色多普勒明确颈动脉粥样硬化斑块且年龄高于75岁患者,随机分为观察组(68例)和对照组(75例),采用单盲(singleblind)方法观察,观察组采用瑞舒伐他汀联合依折麦布治疗,对照组采用瑞舒伐他汀+安慰剂治疗,连续观察6个月后,比较两组治疗前后一般临床资料,包括一般常规资料：患者年龄、性别、既往糖尿病史、既往高血压史、既往吸烟史(吸烟指数)；入院时常规生化指标：包括总淋巴细胞计数、血红蛋白、C-反应蛋白、纤维蛋白原、血小板计数、低密度脂蛋白(LDL-C)水平、肌酐水平、国际标准化比值、总胆固醇(TG)水平、总甘油三酯水平、高密度脂蛋白(HDL-C)水平；影像学资料：颈动脉狭窄程度、斑块的面积及斑块的分型。对两组资料进行比较,评估两种治疗方案的效果。结果入组的143例患者中,两组资料的一般情况包括(既往高血压病史、糖尿病史、吸烟、饮酒史等)无统计学差异,治疗6个月后,两组颈动脉内膜斑块面积均减少,血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)均有所降低,高密度脂蛋白胆固醇(HDL-C)水平升高；观察组较对照组相比,颈动脉内膜斑块分型改善显著、斑块面积及TC、TG、LDL均减少明显,差异有统计学意义(P0.05)。结论瑞舒伐他汀联合依折麦布能够明显逆转颈动脉粥样硬化斑块,降低血脂水平,安全有效。
[Abstract]:Background carotid atherosclerosis is one of the risk factors of ischemic cerebrovascular disease. In elderly patients with carotid atherosclerotic plaque, statins combined with Ezeimebum can not only reverse the plaque, reduce the short-term benefits of ischemic stroke, but also prolong the survival and improve the quality of life. Objective to collect the clinical data of patients with carotid atherosclerotic plaques, and to evaluate the curative effect of rosuvastatin combined with ezeimebur and resuvastatin alone on elderly patients with carotid atherosclerotic plaques. Clinical application in elderly patients with carotid atherosclerotic plaque. Methods from March 2012 to December 2013, 143 patients with carotid atherosclerotic plaques, aged more than 75 years, were selected and randomly divided into observation group (n = 68) and control group (n = 75). The observation group was treated with rosuvastatin combined with ezeimebumin, while the control group was treated with recuvastatin placebo. After 6 months of continuous observation, the general clinical data before and after treatment were compared between the two groups, including general routine data: age and sex of the patients. Previous history of diabetes, history of hypertension, history of smoking (smoking index), routine biochemical parameters at admission: total lymphocyte count, hemoglobin C reactive protein, fibrinogen, platelet count, Low density lipoprotein (LDL-C) level, creatinine level, international standardized ratio, total cholesterol (TG) level, total triglyceride level, high density lipoprotein (HDL-C) level, imaging data: carotid artery stenosis, plaque area and plaque classification. Two groups of data were compared to evaluate the effectiveness of the two treatments. Results there was no significant difference in the general data of the two groups (history of hypertension, diabetes, smoking, alcohol consumption, etc.). After 6 months of treatment, the area of carotid artery intima plaque decreased in both groups. The levels of serum total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) were decreased, and the levels of high density lipoprotein cholesterol (HDL-C) were increased. Plaque area and TCU TGG LDL decreased significantly (P0.05). Conclusion Risuvastatin combined with Ezeimebum can significantly reverse carotid atherosclerotic plaque, reduce blood lipid level, and is safe and effective.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743
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本文编号：2072217