發(fā)布時(shí)間：2018-06-27 01:51

  本文選題：瑞舒伐他汀 + 依折麥布��； 參考：《新鄉(xiāng)醫(yī)學(xué)院》2014年碩士論文

【摘要】：背景頸動(dòng)脈粥樣硬化是缺血性腦血管病的危險(xiǎn)因素之一,注重對頸動(dòng)脈粥樣硬化斑塊的研究則對腦卒中的發(fā)生、發(fā)展及防治有深遠(yuǎn)的意義。他汀類藥物聯(lián)合依折麥布對于高齡頸動(dòng)脈粥樣硬化斑塊患者,不僅能獲得斑塊的逆轉(zhuǎn)、降低缺血性腦卒中發(fā)生率的近期獲益,更有生存期延長、生存質(zhì)量提高的遠(yuǎn)期獲益。目的收集頸動(dòng)脈粥樣硬化斑塊患者的臨床資料,通過隨診觀察,臨床評估瑞舒伐他汀聯(lián)合依折麥布治療及單純?nèi)鹗娣ニ≈委煂Ω啐g頸動(dòng)脈粥樣硬化斑塊患者的療效差異,與導(dǎo)臨床對高齡頸動(dòng)脈粥樣硬化斑塊患者的臨床用藥。方法收集2012年3月——2013年12月我院143例經(jīng)頸動(dòng)脈彩色多普勒明確頸動(dòng)脈粥樣硬化斑塊且年齡高于75歲患者,隨機(jī)分為觀察組(68例)和對照組(75例),采用單盲(singleblind)方法觀察,觀察組采用瑞舒伐他汀聯(lián)合依折麥布治療,對照組采用瑞舒伐他汀+安慰劑治療,連續(xù)觀察6個(gè)月后,比較兩組治療前后一般臨床資料,包括一般常規(guī)資料：患者年齡、性別、既往糖尿病史、既往高血壓史、既往吸煙史(吸煙指數(shù))；入院時(shí)常規(guī)生化指標(biāo)：包括總淋巴細(xì)胞計(jì)數(shù)、血紅蛋白、C-反應(yīng)蛋白、纖維蛋白原、血小板計(jì)數(shù)、低密度脂蛋白(LDL-C)水平、肌酐水平、國際標(biāo)準(zhǔn)化比值、總膽固醇(TG)水平、總甘油三酯水平、高密度脂蛋白(HDL-C)水平；影像學(xué)資料：頸動(dòng)脈狹窄程度、斑塊的面積及斑塊的分型。對兩組資料進(jìn)行比較,評估兩種治療方案的效果。結(jié)果入組的143例患者中,兩組資料的一般情況包括(既往高血壓病史、糖尿病史、吸煙、飲酒史等)無統(tǒng)計(jì)學(xué)差異,治療6個(gè)月后,兩組頸動(dòng)脈內(nèi)膜斑塊面積均減少,血清總膽固醇(TC)、甘油三酯(TG)、低密度脂蛋白膽固醇(LDL-C)均有所降低,高密度脂蛋白膽固醇(HDL-C)水平升高；觀察組較對照組相比,頸動(dòng)脈內(nèi)膜斑塊分型改善顯著、斑塊面積及TC、TG、LDL均減少明顯,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論瑞舒伐他汀聯(lián)合依折麥布能夠明顯逆轉(zhuǎn)頸動(dòng)脈粥樣硬化斑塊,降低血脂水平,安全有效。
[Abstract]:Background carotid atherosclerosis is one of the risk factors of ischemic cerebrovascular disease. In elderly patients with carotid atherosclerotic plaque, statins combined with Ezeimebum can not only reverse the plaque, reduce the short-term benefits of ischemic stroke, but also prolong the survival and improve the quality of life. Objective to collect the clinical data of patients with carotid atherosclerotic plaques, and to evaluate the curative effect of rosuvastatin combined with ezeimebur and resuvastatin alone on elderly patients with carotid atherosclerotic plaques. Clinical application in elderly patients with carotid atherosclerotic plaque. Methods from March 2012 to December 2013, 143 patients with carotid atherosclerotic plaques, aged more than 75 years, were selected and randomly divided into observation group (n = 68) and control group (n = 75). The observation group was treated with rosuvastatin combined with ezeimebumin, while the control group was treated with recuvastatin placebo. After 6 months of continuous observation, the general clinical data before and after treatment were compared between the two groups, including general routine data: age and sex of the patients. Previous history of diabetes, history of hypertension, history of smoking (smoking index), routine biochemical parameters at admission: total lymphocyte count, hemoglobin C reactive protein, fibrinogen, platelet count, Low density lipoprotein (LDL-C) level, creatinine level, international standardized ratio, total cholesterol (TG) level, total triglyceride level, high density lipoprotein (HDL-C) level, imaging data: carotid artery stenosis, plaque area and plaque classification. Two groups of data were compared to evaluate the effectiveness of the two treatments. Results there was no significant difference in the general data of the two groups (history of hypertension, diabetes, smoking, alcohol consumption, etc.). After 6 months of treatment, the area of carotid artery intima plaque decreased in both groups. The levels of serum total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) were decreased, and the levels of high density lipoprotein cholesterol (HDL-C) were increased. Plaque area and TCU TGG LDL decreased significantly (P0.05). Conclusion Risuvastatin combined with Ezeimebum can significantly reverse carotid atherosclerotic plaque, reduce blood lipid level, and is safe and effective.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R743
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本文編號：2072217