CAJ | 학술논문

目的：探讨阿托伐他汀联合甲钴胺对脑梗死患者同型半胱氨酸（Hcy）、血脂及神经功能的影响。方法选择延安市人民医院2011年1月—2013年1月收治的脑梗死患者80例，按照随机数字表分为观察组和对照组，各40例。在常规治疗的基础上，对照组患者给予阿托伐他汀口服治疗，观察组患者在对照组基础上给予甲钴胺片口服治疗。比较两组患者治疗前及治疗后3 d、7 d 和14 d 血清 Hcy 水平和血脂指标〔包括总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白（HDL）及低密度脂蛋白（LDL）〕，并比较两组患者治疗前及治疗后14 d 中国卒中量表（CSS）评分。结果治疗前和治疗后14 d 两组患者血清 Hcy 水平比较，差异无统计学意义（P >0.05）；治疗后3 d 及7 d 观察组患者血清 Hcy 水平低于对照组（P <0.05）。治疗前两组患者血清 TC、TG、HDL 及 LDL 水平比较，差异无统计学意义（P >0.05）；治疗后3 d、7 d 及14 d 观察组患者血清 TC、TG 及 LDL 水平低于对照组，血清 HDL 水平高于对照组（P<0.05）。治疗前两组患者 CSS 评分比较，差异无统计学意义（P >0.05）；治疗后14 d 观察组患者 CSS 评分低于对照组（P <0.05）。结论阿托伐他汀联合甲钴胺可降低脑梗死患者血清 Hcy 水平，改善患者血脂及神经功能。
목적：탐토아탁벌타정연합갑고알대뇌경사환자동형반광안산（Hcy）、혈지급신경공능적영향。방법선택연안시인민의원2011년1월—2013년1월수치적뇌경사환자80례，안조수궤수자표분위관찰조화대조조，각40례。재상규치료적기출상，대조조환자급여아탁벌타정구복치료，관찰조환자재대조조기출상급여갑고알편구복치료。비교량조환자치료전급치료후3 d、7 d 화14 d 혈청 Hcy 수평화혈지지표〔포괄총담고순（TC）、삼선감유（TG）、고밀도지단백（HDL）급저밀도지단백（LDL）〕，병비교량조환자치료전급치료후14 d 중국졸중량표（CSS）평분。결과치료전화치료후14 d 량조환자혈청 Hcy 수평비교，차이무통계학의의（P >0.05）；치료후3 d 급7 d 관찰조환자혈청 Hcy 수평저우대조조（P <0.05）。치료전량조환자혈청 TC、TG、HDL 급 LDL 수평비교，차이무통계학의의（P >0.05）；치료후3 d、7 d 급14 d 관찰조환자혈청 TC、TG 급 LDL 수평저우대조조，혈청 HDL 수평고우대조조（P<0.05）。치료전량조환자 CSS 평분비교，차이무통계학의의（P >0.05）；치료후14 d 관찰조환자 CSS 평분저우대조조（P <0.05）。결론아탁벌타정연합갑고알가강저뇌경사환자혈청 Hcy 수평，개선환자혈지급신경공능。
Objective To investigate the impact of atorvastatin combined with mecobalamin on homocysteine,blood lipids and neurological function of patients with cerebral infarction. Methods A total of 80 patients with cerebral infarction were selected in the People's Hospital of Yan'an from January 2011 to January 2013,and they were randomly divided into observation group and control group,each of 40 cases. Based on conventional treatment,patients of control group were given atorvastatin, while patients of observation group were given atorvastatin combined with mecobalamin. Serum homocysteine level and blood lipids index(including TC,TG,HDL and LDL)before treatment and after 3 days,7 days and 14 days of treatment were compared between the two groups,Chinese Stroke Scale(CCS)score before treatment and after 14 days of treatment were also compared. Results No statistically significant differences of serum homocysteine level was found between the two groups before treatment or after 14 days of treatment(P > 0. 05),while serum homocysteine level of observation group was statistically significantly lower than that of control group after 3 day,7 days of treatment,respectively(P < 0. 05). No statistically significant differences of serum level of TC,TG,HDL or LDL was found between the two groups before treatment(P > 0. 05);after 3 days,7 days and 14 days of treatment,serum levels of TC,TG and LDL of observation group were statistically significantly lower than those of control group,while serum HDL level of observation group was statistically significantly higher than that of control group, respectively(P < 0. 05). No statistically significant differences of CCS score was found between the two groups before treatment (P > 0. 05),while CCS score of observation group was statistically significantly lower than that of control group after 14 days of treatment(P < 0. 05). Conclusion Atorvastatin combined with mecobalamin can effectively reduce the serum homocysteine level of patients with cerebral infarction,improve the blood lipid metabolism and neurological function.