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魏雨雨,尹剑,庞晓俊,陈怀,吕庆平,金许洪.氯吡格雷联合阿托伐他汀治疗进展性脑梗死伴颈动脉粥样斑块疗效及对IMT及NIHSS、Barthel指数的影响[J].浙江中西医结合杂志,2018,28(9):
氯吡格雷联合阿托伐他汀治疗进展性脑梗死伴颈动脉粥样斑块疗效及对IMT及NIHSS、Barthel指数的影响
Effect of clopidogrel combined with atorvastatin on IMT and NIHSS, Barthel index in patients with progressive cerebral infarction and carotid atherosclerotic plaquesWei-Yuyu,Yin-jian,Pang-xiaojun,Chen-huai,Lv-qingping,Jin-xuhong. Department of Neurosurgery, Hangzhou Red Cross Hospital, Hangzhou 310003,China
投稿时间:2018-07-10  修订日期:2018-07-10
DOI:
中文关键词:  进展性脑梗死  颈动脉粥样斑块  颈动脉内膜中层厚度  NIHSS评分  Barthel指数  氯吡格雷  阿托伐他汀
英文关键词:clopidogrel  atorvastatin  progressive cerebral infarction  NIHSS score  Barthel index  cervical atherosclerotic plaque
基金项目:杭州市科学技术委员会资助项目(No.20150633B28)
作者单位E-mail
魏雨雨 杭州市红十字会医院 402193003@qq.com 
尹剑 杭州市红十字会医院 yin_010@sohu.com 
庞晓俊 杭州市红十字会医院  
陈怀 杭州市红十字会医院  
吕庆平 杭州市红十字会医院  
金许洪 杭州市红十字会医院  
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中文摘要:
      目的 观察氯吡格雷联合阿托伐他汀治疗进展性脑梗死伴颈动脉粥样斑块疗效及对IMT及NIHSS、Barthel指数的影响。方法 进展性脑梗死伴颈动脉粥样斑块患者138例,随机分为对照组和观察组,各69例。两组均给予常规治疗,对照组同时给予对照组患者同时口服硫酸氢氯吡格雷片治疗,首次给予负荷剂量300mg,后续给予75mg,1天1次。观察组患者给予量氯吡格雷片(剂量、用法同对照组)加用阿托伐他汀钙片40mg,1天1次,睡前顿服。两组均连续治疗4周。治疗前后检测两组患者颈内动脉中-内膜厚度( IMT) 及斑块最大厚度,检测斑块数目及稳定情况并计算其面积;神经功能缺损评分(NIHSS)、日常生活活动能力量表(BI)评分;比较两组临床疗效、血脂水平及不良反应发生率。结果 观察组治愈率和总有效率均明显高于对照组(P<0.05,P<0.01);观察组治疗后NIHSS评分低于对照组(P<0.05),Barthel指数高于对照组(P<0.05);治疗后观察组患者血TG、LDL-C、TC水平显著降低,HDL-C明显增高,与对照组比较,差异有统计学意义(P均<0.05);观察组颈动脉IMT、斑块最大厚度、斑块面积及不稳定斑块数均显著低于对照组(P均<0.05)。两组患者不良反应发生率差异无统计学意义(P>0.05)。结论 氯吡格雷联合阿托伐他汀治疗进展性脑梗死伴颈动脉粥样斑块患者疗效显著。能降低IMT、斑块厚度及斑块面积,稳定斑块,改善患者神经功能缺损症状,提高患者生活质量。
英文摘要:
      : Objective: To study the effect of clopidogrel combined with atorvastatin on IMT and NIHSS, Barthel index in patients with progressive cerebral infarction and carotid atherosclerotic plaque, and evaluate the clinical value of combination therapy.Methods:Chose 138 patients with progressive cerebral infarction with atherosclerotic plaque in our hospital from May 2015 to May 2016.They were randomly divided into control group (69 example) and study group (69 cases) . The cases in the study group were treated with atorvastatin 40 mg / d and treated with clopidogrel for the first dose of 300 mg and the additional dose of 75 mg / d. The thickness of intima-media (IMT) and the maximum thickness of the internal carotid arteries were measured before and after treatment.Detect the number of patches and stability and calculate the area.The number and stability of plaque were measured and the area was calculated. Used neurological deficits (NIHSS) scale and the Barthel index scale to assess patients before and after treatment;Compared the total effective rate, blood lipid level and adverse reaction between the two groups. Compared the NIHSS score and the Barthel index were between the two groups before and after treatment.Results:After treatment, the total effective rate of treatment, BI index and HDL-C level in the study group were significantly higher than those in the control group (P <0.05);The scores of NIHSS and LDL-C, TG and TC in the study
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