摘要
目的观察强化阿托伐他汀治疗缺血性脑卒中的疗效,并探讨其对患者血清血管性假血友病因子(vWF)和血管内皮细胞钙黏蛋白(VE-cadherin)水平的影响。方法选取2016年1月至2018年5月在上海市杨浦区市东医院就诊的84例缺血性脑卒中患者,采用随机数字表将纳入患者随机分为强化组和对照组,每组42例。两组患者均予以抑制血小板聚集、脑神经保护及维持水电解质平衡基础治疗,并根据患者的病情酌情予以脱水药物降低颅内压、控制血压和血糖等治疗。对照组在此基础上口服阿托伐他汀钙片20 mg,1次/d;强化组在此基础上口服阿托伐他汀钙片40 mg,1次/d,两组均连用4周。检测并比较两组患者治疗前后的血清vWF和VE-cadherin水平,并比较其临床疗效及药物不良反应。结果治疗4周后,强化组与对照组患者血清vWF [(112.03±25.81)%vs (136.21±20.42)%]和VE-cadherin水平[(3.71±0.62) mg/L vs (4.86±0.74) mg/L]较治疗前[(170.12±30.15)%vs (167.62±29.57)%、(5.89±1.17) mg/L vs (5.97±1.08) mg/L]均不同程度下降,且强化组下降幅度大于对照组,差异有统计学意义(P<0.05);同时,强化组患者的临床治疗总有效率为95.24%,优于对照组的80.95%,差异有统计学意义(P<0.05);对照组和强化组治疗期间分别出现不良反应2例(4.76%)与5例(11.90%),症状较轻,两组比较差异无统计学意义(P>0.05)。结论缺血性脑卒中予以强化阿托伐他汀治疗后临床疗效较常规治疗的效果更显著,药物安全性亦较好。
Objective To observe the curative effect of strengthening atorvastatin in the treatment of patients with ischemic stroke and the effect on von Willebrand factor(vWF) and vascular endothelial-cadherin(VE-cadherin) levels. Methods A total of 84 patients with ischemic stroke, who treated in the Yangpu City East Hospital of Shanghai City from January 2016 to May 2018, were selected and divided into the strengthened group(n=42) and the control group(n=42) according to random number table method. The patients in the two groups were given basic medical treatment,such like antiplatelet aggregation, neural protection and maintenance water and electrolyte balance aetc. Furthermore, according to the patient’s condition, dehydration drugs were used to reduce intracranial pressure, control blood pressure and blood sugar. The patients in the control group were given oral 20 mg atorvastatin calcium tablets, once a day, while the patients in the strengthened group were additionally given 40 mg atorvastatin calcium tablets, once a day for 4weeks. The changes of serum v WF and VE-cadherin levels of patients in the two groups before and after medical treatment were detected and compared, and the clinical curative effect and drug adverse reaction(DAR) were compared as well. Results After 4 weeks’ medical treatment, the serum v WF [(112.03±25.81)%,(136.21±20.42)%] and VE-cadherin [(3.71±0.62) mg/L,(4.86±0.74) mg/L] levels of patients in the strengthened group and control group were obviously declined than(170.12±30.15)%,(167.62±29.57)%;(5.89±1.17) mg/L,(5.97±1.08) mg/L before treatment with different degrees, and the declining rate of patients in the strengthened group was much higher than that in the control group,with statistically significant difference(all, P<0.05). Meanwhile, the total clinical efficiency of patients in the strengthened group was 95.24%, which was significantly higher than 80.95% in the control group(P<0.05). There were 2(4.76%) and 5(11.90%) cases of untoward effect in the control group and strengmthened group during the medical treatment, with light symptom, and after comparing the untoward effect of patients in the two groups, no statistical differences were appeared(P>0.05). Conclusion The intensive lipid-lowering with atorvastatin has significant curative effect on ischemic stroke with high security.
作者
陈德艳
周慧
陈赟
吴敏
CHEN De-yan;ZHOU Hui;CHEN Yun;WU Min(Department of Neurology,the Yangpu City East Hospital of Shanghai City,Shanghai 200438,CHINA)
出处
《海南医学》
CAS
2019年第2期163-165,共3页
Hainan Medical Journal
关键词
缺血性脑卒中
阿托伐他汀
强化降脂
血栓调节蛋白
血管内皮细胞钙黏蛋白
Ischemic stroke
Atorvastatin
Intensive lipid-lowering
von Willebrand factor (vWF)
Vascular endothelial-cadherin (VE-Cadherin)
