目的 分析阿托伐他汀聯(lián)合氯吡格雷治療短暫性腦缺血發(fā)作的臨床療效。方法 以2013年1月-2015年8月榆林市星元醫(yī)院收治的短暫性腦缺血發(fā)作患者92例為研究對(duì)象，根據(jù)就診病歷號(hào)順序分為觀察組和對(duì)照組，每組46例，對(duì)照組給予氯吡格雷，觀察組在對(duì)照組的用藥基礎(chǔ)上加用阿托伐他汀，比較兩組的臨床療效、血清超敏C反應(yīng)蛋白（hs-CPR）和脂蛋白相關(guān)磷脂酶A2（Lp-PLA2）水平變化等近期療效指標(biāo)，以及血脂水平、凝血功能、暫性腦缺血發(fā)作和腦梗死發(fā)生率等遠(yuǎn)期療效及治療期間不良反應(yīng)發(fā)生情況。結(jié)果 治療后，觀察組的總有效率為91.3%，顯著高于對(duì)照組的73.9%；治療后1個(gè)月，觀察組和對(duì)照組的hs-CPR和Lp-PLA2水平均較治療前顯著降低（P<0.05），且觀察組顯著低于對(duì)照組（P<0.05）；治療1年后，觀察組的總膽固醇（TC）、三酰甘油（TG）和低密度脂蛋白（LDL）水平均顯著低于治療前及對(duì)照組（P<0.05），觀察組和對(duì)照組的血小板計(jì)數(shù)（PLT）、凝血酶原時(shí)間（PT）、活化部分凝血酶時(shí)間（APTT）比較，差異均無(wú)統(tǒng)計(jì)學(xué)意義；隨訪1年中，觀察組短暫性腦缺血發(fā)作再發(fā)率和腦梗死發(fā)生率均顯著低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療期間，兩組不良反應(yīng)發(fā)生率比較，差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 與單用氯吡格雷相比，阿托伐他汀聯(lián)合氯吡格雷治療短暫性腦缺血發(fā)作的近期療效及遠(yuǎn)期療效顯著，且不增加不良反應(yīng)。

Objective To investigate the clinical effect of atorvastatin combined with lopidogrel in patients with transient ischemic attack. Methods Totally 92 cases of patients with transient ischemic attack in Xingyuan Hospital of Yulin City from January 2013 to August 2015 were divided into observation group and control group, 46 cases in each group. Patients in observation group were treated with atorvastatin combined with lopidogrel, and patients in control group were treated with lopidogrel. The differences in short term effect, long-term effect, and adverse reaction between two groups were compared. Results The total effective rate of observation group was significantly higher than that of control group (P<0.05);After treatment, the levels of hs-CPR, Lp-PLA2TC, TG, and LDL, the recurrence rate of transient ischemic attack and the incidence of cerebral infarction of the observation group were significantly lower than that of the control group and before treatment (P<0.05), but the differences in PLT, PT, and APTT between two groups before and after treatment were not significant. Conclusion The clinical effect of atorvastatin combined with lopidogrel in patients with transient ischemic attack were remarkable, and the incidence of adverse events do not increase.