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目的探讨他汀类药物短期给药对缺血性脑梗死患者载脂蛋白水平的影响。方法选取96例缺血性脑梗死患者为研究对象,按照随机数字表法将其分成研究A组、研究B组和对照组,每组32例。对照组予以常规治疗措施,研究A组在常规治疗的基础上联合阿托伐他汀短期口服方案,研究B组在常规治疗基础上联合辛伐他汀口服方案,持续治疗7 d后观察疗效。对比三组患者治疗前后美国国立卫生院神经功能缺损评分(NIHSS)情况,记录其载脂蛋白水平变化,分析用药不良反应发生情况。结果 1治疗7 d后,三组NIHSS评分结果均较治疗前显著降低(P<0.05),其中研究A组降幅最大,其次为研究B组,对照组降幅最小(P<0.05);2除对照组治疗前后载脂蛋白水平比较差异未见统计学意义外(P>0.05),两个研究组患者APOA1、APOB、APOB/APOA1等载脂蛋白水平均较治疗前显著降低(P<0.05),其中研究A组降幅明显大于研究B组(P<0.05);3三组患者均未发生严重不良反应,其中对照组用药不良反应发生率最低,其次为研究A组,研究B组不良反应发生率最高,但研究A组与其他两组不良反应发生率对比差异未见统计学意义(P>0.05);对照组和研究B组不良反应发生率对比差异有统计学意义(P<0.05)。结论在常规治疗的基础上联合他汀类药物可起到理想的降脂、调节载脂蛋白水平的效果,同等剂量的阿托伐他汀疗效优于辛伐他汀,且不良反应轻微,用药安全性理想,于缺血性脑梗死患者神经功能恢复及预后提升有利。
Objective To investigate the effects of short-term administration of statins on apolipoprotein levels in patients with ischemic cerebral infarction. Methods Ninety-six patients with ischemic stroke were selected as research objects. According to the random number table, they were divided into study group A, study group B and control group, with 32 cases in each group. The patients in control group were given routine treatment. The patients in group A were treated with short-term oral atorvastatin on the basis of conventional treatment. The patients in group B were treated with simvastatin orally on the basis of routine treatment. The therapeutic effect was observed after 7 days of continuous treatment. Before and after treatment, the National Institutes of Health neurological deficit score (NIHSS) was compared between the three groups. The change of apolipoprotein level was recorded and the incidence of adverse drug reactions was analyzed. Results After 7 days of treatment, the NIHSS score of the three groups was significantly lower than that before treatment (P <0.05), the greatest decrease was seen in group A, the second was in study group B, and the lowest in control group (P <0.05) The levels of apolipoproteins APOA1, APOB, APOB / APOA1 and other apolipoproteins in the two study groups were significantly lower than those before treatment (P <0.05), but no significant difference The decrease of group A was significantly greater than that of group B (P <0.05). No serious adverse reactions occurred in the three groups of patients, and the incidence of adverse reactions in the control group was the lowest, followed by study group A, and the incidence of adverse reactions in group B But there was no significant difference between the two groups (P> 0.05). There was significant difference in adverse reactions between control group and study group B (P <0.05). Conclusion The combination of statins and conventional statins can be an ideal lipid-lowering and apolipoprotein-lowering effect. Atorvastatin with the same dosage is superior to simvastatin with less adverse reactions and the safety of medication is ideal , In patients with ischemic cerebral infarction improved neurological function and prognosis improve.