發(fā)布時(shí)間：2018-09-06 16:19

【摘要】：目的:探討阿托伐他汀對(duì)腔隙性腦梗死患者血糖代謝的影響,并對(duì)其進(jìn)行藥效及安全性分析,觀察它對(duì)LDL-C/HDL-C的作用。方法:采用回顧性病例分析的研究方法,通過我院電子病歷查詢系統(tǒng)篩選自2013年1月1日至2016年12月31日在我院住院的腔隙性腦梗死患者的基本信息,收集其基線值和歷次隨診的相關(guān)資料,主要指標(biāo)包括空腹血糖、糖化血紅蛋白、餐后2h血糖、血脂四項(xiàng)、肝功能、腎功能、肌酸激酶等。根據(jù)患者服用阿托伐他汀的時(shí)間(t)長短分為3個(gè)隨訪組,分別為隨訪組1(0t≤6個(gè)月)、隨訪組2(6t≤12個(gè)月)、隨訪組3(t12個(gè)月);此外,按照年齡段劃分將各隨訪組中的隨訪對(duì)象分為中年組(40-65歲)和老年組(66歲以上),通過運(yùn)用SPSS17.0統(tǒng)計(jì)學(xué)軟件對(duì)基線值和終末值指標(biāo)進(jìn)行比較,觀察阿托伐他汀(20mg/d)對(duì)腔隙性腦梗死患者的空腹血糖、糖化血紅蛋白有無影響,對(duì)低密度脂蛋白膽固醇/高密度脂蛋白膽固醇比值(LDL-C/HDL-C)有何作用,并對(duì)阿托伐他汀的藥效及安全性進(jìn)行分析。結(jié)果:納入腔隙性腦梗死患者共156例,隨訪終末期發(fā)生1例新發(fā)糖尿病,而各隨訪組的前后對(duì)比以及中年組和老年組間對(duì)比,空腹血糖、糖化血紅蛋白均無差異性改變,但老年組的糖化血紅蛋白隨著服用阿托伐他汀的時(shí)間的延長有升高的趨勢(shì)。各隨訪組終末期的血清總膽固醇(TC)及低密度脂蛋膽固醇水平(LDL-C)較基線值明顯降低,HDL-C水平較基線值輕度升高,前兩者前后差異具有顯著統(tǒng)計(jì)學(xué)意義,各隨訪組終末期LDL-C/HDL-C比值較基線期下降,且服用阿托伐他汀的時(shí)間越長,該比值有降低的趨勢(shì)。隨訪終末期發(fā)生肝酶升高共3人,占1.92%,肌酶升高共2人,占1.28%,均未出現(xiàn)肌肉疼痛、腹瀉、惡心等不良反應(yīng),亦無多飲、多食、多尿、明顯消瘦等癥狀。結(jié)論:阿托伐他汀對(duì)腔隙性腦梗死患者的空腹血糖、糖化血紅蛋白無明顯影響,但其隨著服用時(shí)間的延長具有升高老年人糖化血紅蛋白的風(fēng)險(xiǎn),老年人在長期服用他汀時(shí)需注意監(jiān)測(cè)血糖代謝相關(guān)指標(biāo)的變化;阿托伐他汀可降低腔隙性腦梗死患者的LDL-C/HDL-C的比值,具有良好的降脂作用及安全性。
[Abstract]:Aim: to investigate the effect of Atto vastatin on blood glucose metabolism in patients with lacunar cerebral infarction, and to analyze its efficacy and safety, and to observe its effect on LDL-C/HDL-C. Methods: the basic information of patients with lacunar cerebral infarction who were hospitalized in our hospital from January 1, 2013 to December 31, 2016 was screened through the electronic medical record query system of our hospital by retrospective case analysis. The baseline values and previous follow-up data were collected, including fasting blood glucose, glycosylated hemoglobin, 2 h postprandial blood glucose, four items of blood lipids, liver function, renal function, creatine kinase and so on. According to the duration of (t), the patients were divided into three follow-up groups: group 1 (0 t 鈮，

本文編號(hào)：2226888