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目的 :探讨辛伐他汀对颈动脉粥样斑块的影响和对脑梗死的干预作用。方法 :将 86例患者分为治疗组和对照组各 43例。治疗组给以辛代他汀 10mg/d ,睡前 1次口服 ,共服 1年 ;对照组采用藻酸双酯钠 0 1每日 2次口服 ,其他治疗方法两组基本相同。治疗前及治疗后 3个月、6个月、12个月分别复查血脂、颈动脉超声 ,并作临床症状如脑缺血发作的随访登记。结果 :治疗组服药前软斑 2 0例 ,硬斑 2 3例 ,疗程结束后软斑 6例 ,硬斑 3 7例 ;对照组治疗前软斑 19例 ,硬斑 2 3例 ,疗程结束后软斑 14例 ,硬斑 2 9例。斑块最大直径在服药 12月后 ,治疗组 ( 1 2 6± 0 5 8)cm ,对照组 ( 1 3 2± 0 5 6)cm ,P <0 0 5。治疗组发生脑梗死 2例。对照组发生脑梗死 12例。结论 :辛伐他汀对粥样斑块成分的影响大于对形态、大小的影响 ,且阻止斑块继续扩大并稳定斑块作用 ,是高危患者预防脑梗死的有效药物之一。
Objective: To investigate the effect of simvastatin on carotid artery atherosclerotic plaque and its effect on cerebral infarction. Methods: 86 patients were divided into treatment group and control group, 43 cases each. The treatment group was given Xin Dai statin 10mg / d, 1 times before going to bed orally for a total of 1 year; control group with sodium alginate 0 1 2 times daily oral administration, other treatment methods were basically the same in both groups. Before treatment and 3 months after treatment, 6 months, 12 months were reviewed lipid, carotid artery ultrasound, and for clinical symptoms such as ischemic attack follow-up registration. Results: In the treatment group, there were 20 cases of soft spots before treatment, 23 cases of hard spots, 6 cases of soft spots after operation, and 37 cases of hard spots. In the control group, 19 cases of soft spots before treatment and 23 cases of hard spots 14 cases of soft spot, 29 cases of hard spot. The maximum diameter of the plaque was 12 6 ± 0 58 cm in the treated group and 122 ± 0 56 in the control group, P <0 05 after 12 months of treatment. The treatment group had cerebral infarction in 2 cases. Control group occurred in 12 cases of cerebral infarction. Conclusion: Simvastatin has more effect on atherosclerotic plaque components than morphology and size, and prevents plaque from expanding and stabilizing plaque. It is one of the effective drugs for preventing cerebral infarction in high-risk patients.