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目的探讨依折麦布辅助强化调脂对短暂性脑缺血发作(transient ischemic attack,TIA)患者血脂和颈动脉粥样硬化斑块的影响。方法选择2013年1月—2014年12月收治的TIA合并高脂血症和颈动脉粥样硬化斑块患者126例作为研究对象,随机分为对照组和研究组各63例。对照组给予基础药物治疗,研究组在对照组基础上加服依折麦布辅助强化调脂。检测治疗前后血脂及hs-CRP水平变化情况,彩超观察患者治疗前后颈动脉粥样硬化斑块。计量资料组间比较采用t检验,组内比较采用配对t检验,计数资料采用χ~2检验,P<0.05为差异有统计学意义。结果治疗后,研究组与对照组TC、TG、LDL-C和hs-CRP水平分别为(3.75±0.48)、(1.74±0.49)、(1.75±0.58)mmol/L、(5.18±1.23)mg/L、(4.86±0.62)、(1.72±0.53)、(2.72±0.61)mmol/L、(5.21±1.59)mg/L,与治疗前的(6.71±0.73)、(2.23±0.67)、(3.52±0.63)mmol/L、(7.41±1.64)mg/L、(6.70±0.84)、(2.21±0.62)、(3.53±0.46)mmol/L、(7.37±1.65)mg/L比较均降低,差异均有统计学意义(均P<0.05)。治疗后,研究组TC和LDL-C水平均低于对照组,差异均有统计学意义(均P<0.05)。研究组强化调脂治疗后,颈动脉粥样硬化斑块最大面积(Smax)为(16.79±2.03)mm2,较治疗前的(22.72±2.01)mm2明显缩小,差异有统计学意义(P<0.05)。治疗后,研究组Smax显著小于对照组的(21.66±1.72)mm2,差异有统计学意义(P<0.05)。结论依折麦布辅助强化调脂可达到进一步降低胆固醇的效果,同时具有缩小动脉粥样硬化斑块的作用,且不良反应较少。
Objective To investigate the effects of ezetimibe-assisted lipid-lowering therapy on serum lipid and carotid atherosclerotic plaque in patients with transient ischemic attack (TIA). Methods 126 cases of TIA complicated with hyperlipidemia and carotid atherosclerosis plaque admitted from January 2013 to December 2014 were selected as study subjects and randomly divided into control group and study group of 63 cases. Control group given basic drug treatment, the study group in the control group plus plus ezetimibe to help enhance lipid regulation. Before and after treatment to detect serum lipid and hs-CRP level changes, color Doppler ultrasound before and after treatment of patients with atherosclerotic plaque. Measurement data were compared between groups using t test, the group was compared using paired t test, count data usingχ ~ 2 test, P <0.05 for the difference was statistically significant. Results After treatment, the levels of TC, TG, LDL-C and hs-CRP in study group and control group were (3.75 ± 0.48), (1.74 ± 0.49), (1.75 ± 0.58) mmol / L and (5.18 ± 1.23) mg (6.72 ± 0.53), (2.72 ± 0.61) mmol / L, (5.21 ± 1.59) mg / L, and before treatment (6.71 ± 0.73), (2.23 ± 0.67), L, (3.52 ± 0.63) mmol / L, (7.41 ± 1.64) mg / L, (6.70 ± 0.84), (2.21 ± 0.62), (3.53 ± 0.46) mmol / L and (7.37 ± 1.65) mg / The differences were statistically significant (all P <0.05). After treatment, the levels of TC and LDL-C in the study group were lower than those in the control group, with significant differences (all P <0.05). In the study group, the maximum area of carotid atherosclerosis was (16.79 ± 2.03) mm2, which was significantly smaller than that before treatment (22.72 ± 2.01) mm2, the difference was statistically significant (P <0.05) ). After treatment, Smax in the study group was significantly lower than that in the control group (21.66 ± 1.72) mm2, the difference was statistically significant (P <0.05). Conclusion Ezetimibe-assisted lipid-lowering can achieve the effect of further reducing cholesterol, meanwhile reducing the atherosclerotic plaque with less adverse reactions.