CAJ | 학술논문

目的：观察阿托伐他汀联合血塞通治疗老年急性脑梗死患者的临床疗效及其对颈动脉粥样硬化斑块、CRP、血脂、凝血功能的影响。方法选择符合入组标准的老年急性脑梗死患者100例，按数字表法随机分为观察组50例、对照组50例，对照组进行常规方法治疗，观察组在对照组的基础上给予阿托伐他汀联合血塞通治疗，3周为1个疗程。治疗前后检测血清CRP、血脂指标及凝血功能，采用彩色多普勒超声诊断仪测定颈动脉内膜中层厚度（IMT）、颈动脉斑块面积，进行神经功能缺损评分（NIHSS）评分，评价两组临床疗效。结果治疗后，观察组凝血酶原时间（ PT）、部分活化凝血酶原时间（ APTT）、CRP、IMT、颈动脉斑块面积、NIHSS评分分别为（18．07±2．24） s、（36．59±3．52） s、（11．2±3．6） mg／L、（0．57±0．16） mm、（1．36±0．32）cm2、（9．31±2．06）分，对照组分别为（15．24±1．88） s、（31．84±2．55） s、（26．4±6．7） mg／L、（0．68±0．13）mm、（1．55±0．37）cm2、（15．86±2．25）分，两组均较治疗前明显改善（均P＜0．05），观察组改善情况均优于对照组，差异均有统计学意义（t＝3．446、3．602、6．042、3．335、3．509、6．003，均P＜0．05或P＜0．01）；观察组总有效率为96％，高于对照组的72％，差异有统计学意义（χ2＝10．867，P＜0．01）。结论阿托伐他汀联合血塞通能有效调节老年急性脑梗死患者血脂水平及凝血功能，抑制血管炎性反应，稳定或逆转颈动脉斑块，缩小颈动脉IMT，抑制血栓形成及进展，改善脑梗死部位缺血缺氧和缺损神经功能，提高临床疗效。
목적：관찰아탁벌타정연합혈새통치료노년급성뇌경사환자적림상료효급기대경동맥죽양경화반괴、CRP、혈지、응혈공능적영향。방법선택부합입조표준적노년급성뇌경사환자100례，안수자표법수궤분위관찰조50례、대조조50례，대조조진행상규방법치료，관찰조재대조조적기출상급여아탁벌타정연합혈새통치료，3주위1개료정。치료전후검측혈청CRP、혈지지표급응혈공능，채용채색다보륵초성진단의측정경동맥내막중층후도（IMT）、경동맥반괴면적，진행신경공능결손평분（NIHSS）평분，평개량조림상료효。결과치료후，관찰조응혈매원시간（ PT）、부분활화응혈매원시간（ APTT）、CRP、IMT、경동맥반괴면적、NIHSS평분분별위（18．07±2．24） s、（36．59±3．52） s、（11．2±3．6） mg／L、（0．57±0．16） mm、（1．36±0．32）cm2、（9．31±2．06）분，대조조분별위（15．24±1．88） s、（31．84±2．55） s、（26．4±6．7） mg／L、（0．68±0．13）mm、（1．55±0．37）cm2、（15．86±2．25）분，량조균교치료전명현개선（균P＜0．05），관찰조개선정황균우우대조조，차이균유통계학의의（t＝3．446、3．602、6．042、3．335、3．509、6．003，균P＜0．05혹P＜0．01）；관찰조총유효솔위96％，고우대조조적72％，차이유통계학의의（χ2＝10．867，P＜0．01）。결론아탁벌타정연합혈새통능유효조절노년급성뇌경사환자혈지수평급응혈공능，억제혈관염성반응，은정혹역전경동맥반괴，축소경동맥IMT，억제혈전형성급진전，개선뇌경사부위결혈결양화결손신경공능，제고림상료효。
Objective To observe the effect and the influence on carotid atherosclerotic plaques,C-reactive protein,lipids,coagulation of atorvastatin and xuesaitong injection in the treatment of elderly patients with acute cere-bral infarction.Methods 100 elderly patients with acute cerebral infarction met inclusion criteria were randomly divided into 50 cases of the observation group and 50 cases of the control group,the control group were given conven-tional therapy,the observation group were given atorvastatin and xuesaitong injection on the basis of the control group, atorvastatin calcium 20mg/d,qd,Xuesetong 400mg/times,qd,both groups had been treated for 3 weeks for a course of treatment,the serum C-reactive protein,serum lipids and coagulation parameters were detected before and after treat-ment,the IMT and carotid plaque area were determined by color Doppler ultrasonography,NIHSS score were calculat-ed.Results The PT,APTT,CRP,IMT,carotid plaque area,NIHSS score of the observation group were (18.07 ± 2.24)s,(36.59 ±3.52)s,(11.2 ±3.6)mg/L,(0.57 ±0.16)mm,(1.36 ±0.32)cm2,(9.31 ±2.06)point,the observation group were (15.24 ±1.88) s,(31.84 ±2.55) s,(26.4 ±6.7) mg/L,(0.68 ±0.13) mm,(1.55 ± 0.37)cm2,(15.86 ±2.25)point,both groups were significantly improved after treatment than before treatment (all P<0.05),The total efficiency of observation group and control group were 96%and 72%,the observation group was significantly higher than those of the control group, the difference was statistically significant (χ2 =10.867, P <0.01).Conclusion The method containing atorvastatin and Xuesaitong injection can effectively regulate blood lipid levels and blood coagulation,inhibit vascular inflammation,Stabilizing or reversing carotid artery plaque,reduce carot-id intima-media thickness,can inhibit thrombosis and progress,improve cerebral hypoxia and ischemia parts neurologi-cal defects,improve clinical outcomes,significantly improved clinical outcomes.