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目的通过观察不同剂量瑞舒伐他汀钙联合丁苯酞氯化钠注射液治疗青年脑梗死患者的疗效,评价两药联合治疗青年脑梗死的临床效果,为改善青年脑梗死的预后提供更多的治疗方法。方法选取2012年5月至2014年5月于保定市第二中心医院神经内科住院的青年脑梗死患者200例,随机分为四组,每组50例,A组:小剂量瑞舒伐他汀钙+常规治疗,B组:大剂量瑞舒伐他汀钙+常规治疗,C组:小剂量瑞舒伐他汀钙+丁苯酞注射液,D组:大剂量瑞舒伐他汀钙+丁苯酞注射液组,分别于治疗前,治疗后14 d、6个月进行NIHSS评分、BI评分及检测高敏反应蛋白(hs-CRP)水平,治疗前及后6个月检测颈动脉内-中膜厚度(IMT),每月查肝肾功能、心肌酶评价药物不良反应。结果四组患者治疗后,NIHSS评分,hs-CRP、TMT均明显降低,BI评分明显升高,与治疗前比较差异有统计学意义;且治疗14 d后,NIHSS评分、hs-CRP值D组C组>B组>A组(F=4.00,P=0.008 6)。治疗6个月后比较,NIHSS评分、IMT、hs-CRP值D组C组>B组>A组(F=3.750,P=0.012 0)。A、B、C、D组不良反应发生率分别为4.00%、6.00%、6.00%、6.00%,差异无统计学意义(χ2=0.323,P=0.851)。结论大剂量瑞舒伐他汀钙联合丁苯肽注射液可显著改善青年脑梗死的短期及长期预后,不良反应轻微。
Objective To observe the curative effect of different dosages of rosuvastatin calcium combined with butylphthalide and sodium chloride injection on young patients with cerebral infarction and to evaluate the clinical effect of combined treatment of two drugs on young cerebral infarction and to provide more treatment method. Methods A total of 200 young patients with cerebral infarction hospitalized in Department of Neurology, the Second Central Hospital of Baoding from May 2012 to May 2014 were randomly divided into four groups with 50 cases in each group. Group A: low dose rosuvastatin calcium + Conventional treatment, group B: high dose rosuvastatin calcium + conventional treatment, group C: low dose rosuvastatin calcium + butylphthalide injection, group D: high dose rosuvastatin calcium + butylphthalide injection The NIHSS score, BI score and the level of hs-CRP were measured before treatment, 14 days and 6 months after treatment. The carotid artery intima-media thickness was measured before and 6 months after treatment IMT), monthly check liver and kidney function, myocardial enzyme evaluation of adverse drug reactions. Results After treatment, NIHSS score, hs-CRP, TMT were significantly decreased, BI score was significantly increased, and the difference was statistically significant compared with that before treatment; after 14 d of treatment, NIHSS score, hs-CRP value of D group C group> B group> A Group (F = 4.00, P = 0.008 6). The NIHSS score, IMT, hs-CRP value in group D C group> B group> A group (F = 3.750, P = 0.012 0). The incidences of adverse reactions in groups A, B, C and D were 4.00%, 6.00%, 6.00% and 6.00%, respectively, with no significant difference (χ2 = 0.323, P = 0.851). Conclusion High-dose rosuvastatin calcium combined with DBP can significantly improve the short-term and long-term prognosis of young patients with cerebral infarction with mild adverse reactions.