本文選題：急性缺血性腦卒中 + 他汀強化降脂治療��； 參考：《廣西醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的缺血性腦卒中(Ischemic Stroke,IS)發(fā)病率、死亡率及致殘率高,預(yù)后差,是一種嚴重危害人類健康和生命的常見病。阿托伐他汀由于多效性作用,主要用于預(yù)防和治療心腦血管疾病,而國人卒中患者早期強化降脂治療后,血脂達標率和安全性的研究數(shù)據(jù)較少。本次研究主要評價IS/TIA患者行短期強化降脂治療的臨床療效,為臨床用藥及安全性提供科學(xué)依據(jù)。方法收集2015年6月至2015年12月我院收治的符合納入標準的首發(fā)AIS/TIA患者80例,隨機分為20mg阿托伐他汀常規(guī)劑量治療組28例(A組)、40mg阿托伐他汀治療組27例(B組)和60mg治療組25例(C組)。所有患者在缺血性腦血管病的常規(guī)治療基礎(chǔ)上予不同劑量阿托伐他汀,期間不服用其他調(diào)脂類藥物,觀察并比較3組患者治療前和治療12天后、3個月后的血脂(包括：總膽固醇TC、甘油三酯TG、低密度脂蛋白膽固醇LDL-C、高密度脂蛋白膽固醇HDL-C)、超敏C反應(yīng)蛋白(hs-CRP)、基質(zhì)金屬蛋白酶-9(MMP-9)的變化。同時檢測患者的肝功能及肌酶等不良反應(yīng),ALT/CK升高達正常值上限3/5倍則停藥觀察。記錄住院及隨訪期間病例情況。采用SPSS17.0統(tǒng)計軟件對所有臨床資料和實驗數(shù)據(jù)進行處理,計量資料以X±S表示,組間比較采用方差分析、組內(nèi)比較采用配對t檢驗對數(shù)據(jù)進行統(tǒng)計分析和顯著性檢驗,以P0.05表示差異有統(tǒng)計學(xué)意義。結(jié)果1、所有患者臨床基線水平較一致。2、阿托伐他汀治療12天后,三組TC、TG、LDL-C水平較基線值均降低,差異具有統(tǒng)計學(xué)意義；用藥3個月后,三組LDL-C水平分別降至2.03 ±0.46mmol/L、1.71±0.37mmol/L、1.57±0.44mmol/L,較基線水平分別降幅25.09%、36.43%、44.52%,組間差異具有統(tǒng)計學(xué)意義。3、用藥3個月后,MMP-9和hs-CRP降幅C組最強,A組最弱。4、3組治療前后轉(zhuǎn)氨酶、肌酶變化差異均無統(tǒng)計學(xué)意義,3組均無腦出血發(fā)生。結(jié)論阿托伐他汀強化降脂、抗炎作用依賴于他汀劑量,強化組60mg優(yōu)于40mg組,且短期使用安全性良好。
[Abstract]:Objective the incidence, mortality and disability rate of ischemic stroke are high, and the prognosis is poor. It is a common disease that seriously endangers human health and life. Atto vastatin is mainly used in the prevention and treatment of cardiovascular and cerebrovascular diseases because of its pleiotropic effect. However, there is little data on the rate of blood lipids reaching the standard and the safety of Chinese stroke patients after early intensive lipid-lowering therapy. The purpose of this study was to evaluate the clinical efficacy of short-term intensive lipid lowering in patients with IS/TIA and to provide scientific evidence for clinical use and safety. Methods from June 2015 to December 2015, 80 patients with first-episode AIS/TIA who were admitted to our hospital from June 2015 to December 2015 were collected. They were randomly divided into two groups: group A (n = 28) treated with 20mg Atto vastatin (n = 28) and group B (n = 27) treated with 40 mg Atto vastatin (n = 27) and group C (n = 25) treated with 60mg. All patients were given different doses of Atto vastatin on the basis of routine treatment of ischemic cerebrovascular disease, and no other lipid-regulating drugs were taken during the period. Observe and compare the serum lipids (including total cholesterol TC, triglyceride TG, low density lipoprotein cholesterol LDL-C, high density lipoprotein cholesterol HDL-CU, hypersensitive C-reactive protein hs-CRPU, matrix gold) in 3 groups before and after 12 days of treatment. The change of MMP-9 is a kind of protease. At the same time, liver function and muscle enzyme were detected and alt / CK increased to the upper limit of normal value by 3 / 5 times. The cases were recorded during hospitalization and follow-up. All the clinical data and experimental data were processed by SPSS17.0 software. The measurement data were expressed as X 鹵S, the analysis of variance was used in the inter-group comparison, and the statistical analysis and significance test were performed by paired t test in the intra-group comparison. The difference was statistically significant with P0.05. Results 1. The clinical baseline level was the same in all patients. After 12 days of treatment with Atto vastatin, the LDL-C levels of TCG in the three groups were all lower than the baseline values, and the difference was statistically significant after 3 months of treatment. The LDL-C level of the three groups decreased to 2.03 鹵0.46 mmol / L 1.71 鹵0.37 mmol / L respectively, which was 25.09 鹵0.44 mmol / L, 25.09 and 36.43 mm / L, respectively. The difference between the three groups was statistically significant. After 3 months of treatment, the levels of MMP-9 and hs-CRP in group C were the weakest and the weakest in group A before and after treatment. There was no significant difference in the changes of muscle enzymes between the three groups. Conclusion the antiinflammatory effect of Atto vastatin is dependent on the dosage of statins. The 60mg of the fortified group is better than that of the 40mg group, and the short-term use safety is good.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R743.3

【相似文獻】

相關(guān)期刊論文 前10條

1 yね窳，

本文編號：1904636