目的 探究普羅布考聯(lián)合阿托伐他汀治療急性腦梗死的臨床效果.方法 選取2011年5月—2013年5月首都醫(yī)科大學附屬北京友誼醫(yī)院收治的急性腦梗死患者80例,隨機分為治療組和對照組,每組40例.對照組患者在常規(guī)治療基礎(chǔ)上加服阿托伐他汀片,1片/次,1次/d.治療組在對照組用藥的基礎(chǔ)上加用普羅布考片,4片/次,2次/d.兩組均連續(xù)治療6個月.比較兩組治療前后相關(guān)生化指標、血脂水平、頸動脈粥樣硬化斑塊面積、頸動脈內(nèi)膜中膜厚度.結(jié)果 治療后,兩組患者超敏C反應(yīng)蛋白、氧化低密度脂蛋白(ox-LDL)、基質(zhì)金屬蛋白酶-2(MMP-2)、MMP-9、NIHSS評分均較治療前顯著降低,兩組血清脂聯(lián)素比治療前增加,同組治療前后差異有統(tǒng)計學意義(P<0.05);治療后,治療組這些指標的改善程度優(yōu)于對照組,兩組比較差異有統(tǒng)計學意義(P<0.05).治療后,兩組總膽固醇(TC)、三酰甘油(TG)、低密度脂蛋白膽固醇(LDL-C)水平均較治療前顯著降低,且高密度脂蛋白膽固醇(HDL-C)較治療前顯著升高,同組治療前后比較差異有統(tǒng)計學意義(P<0.05);治療后,治療組TC、TG、LDL-C水平低于對照組,兩組比較差異有統(tǒng)計學意義(P<0.05).兩組患者治療后的斑塊面積和內(nèi)膜中膜厚度均較治療前顯著降低,同組治療前后差異有統(tǒng)計學意義(P<0.05);治療后,治療組這兩個指標均低于對照組,兩組比較差異有統(tǒng)計學意義(P<0.05).結(jié)論 普羅布考聯(lián)合阿托伐他汀治療急性腦梗死患者具有較好的臨床療效,可降低患者血脂水平,抑制動脈粥樣硬化斑塊的發(fā)展,值得臨床推廣應(yīng)用.

Objective To investigate the clinical effect of probucol combined with atorvastatin in treatment of acute cerebral infarction. Methods The patients with acute cerebral infarction (80 cases) of Beijing Friendship Hospital Affiliated to Capital Medical Universityfrom May 2011 to May 2013 were randomly divided into treatment and control groups, and each group had 40 cases. The patients in the control group were po administered with Atorvastatin Tablets on the basis of conventional treatment, one tablet/time, once daily. The patients in the treatment group were po administered with Probucol Tablets at the basis of the control group, 4 tablets/time, twice daily. The patients in two groups were treated for 6 months. The related biochemical indexes, blood lipid levels, area of carotid atherosclerotic plaque, and film thickness of the carotid artery intima in two groups before and after treatment were compared. Results After treatment, hypersensitive C reactive protein, ox-LDL, MMP-2, MMP-9, and NIHSS score in two groups were significantly reduced, while serum level of adiponectin increased, and the difference was statistically significant in the same group before and after treatment (P < 0.05). After treatment, these indicators in the treatment group improved better than those of control group, and there were differences between the two groups (P < 0.05). After treatment, TC, TG, and LDL-C in two groups were significantly reduced, while HDL-C increased, and the difference was statistically significant in the same group before and after treatment (P < 0.05). After treatment, TC, TG, and LDL-C in treatment group were lower than those in the control group, and there were differences between the two groups (P < 0.05). After treatment, the area of carotid atherosclerotic plaque and film thickness of the carotid artery intima in two groups were significantly reduced, and the difference was statistically significant in the same group before and after treatment (P < 0.05). After treatment, the two indicators in the treatment group were lower than those in the control group, and there were differences between the two groups (P < 0.05). Conclusion Probucol combined with atorvastatin has the good clinical effect in treatment of acute cerebral infarction, and can decrease blood lipid level, while can inhibit the development of atherosclerotic plaque, which is worth clinical promotion.