阿托伐他汀联合氯吡格雷及拜阿司匹林对进展性脑梗死患者颈动脉粥样硬化的疗效评价

夏永梅; 于玲; 李兰君; 刘春艳; 叶红晖

doi:10.13898/j.cnki.issn.1000-2200.2016.03.018

阿托伐他汀联合氯吡格雷及拜阿司匹林对进展性脑梗死患者颈动脉粥样硬化的疗效评价

山东省日照市东港区人民医院神经内科, 山东日照 276800

作者简介: 夏永梅(1972-),女,硕士,副主任医师.

中图分类号: R743.33

Effect of the atorvastatin combined with clopidogrel and aspirin in the treatment of carotid arterial sclerosis in patients with progressive cerebral infarction

Department of Neurology, Donggang District Hospital, Rizhao Shandong 276800, China
CLC number: R743.33

摘要: 目的:探讨阿托伐他汀联合氯吡格雷、拜阿司匹林对进展性脑梗死患者颈动脉粥样硬化的疗效。方法:选取进展性脑梗死合并颈动脉粥样硬化患者56例,随机分为对照组和观察组各28例。对照组给予辛伐他汀20 mg+拜阿司匹林300 mg,1次/天,睡前口服;观察组给予阿托伐他汀40 mg+氯吡格雷75 mg+拜阿司匹林100 mg,1次/天,睡前口服。2组疗程均为6个月。分别于治疗前后应用彩色多普勒超声检测2组颈动脉内-中膜厚度(IMT)和粥样硬化斑块最大厚度,并计算斑块面积及数目。结果:2组治疗后颈动脉IMT、斑块最大厚度和斑块面积均较治疗前明显减小(P<0.01);且2组治疗后颈动脉IMT、斑块最大厚度和斑块面积差异均有统计学意义(P<0.05~P<0.01)。在稳定动脉粥样硬化斑块方面,对照组治疗后不稳定斑块数目与稳定斑块数目基本不变;观察组治疗后不稳定斑块数减少15处,稳定斑块增加9处,斑块减少6处,与对照组比较差异有统计学意义(P<0.01)。结论:阿托伐他汀联合氯吡格雷、拜阿司匹林对进展性脑梗死患者颈动脉粥样硬化具有减少颈动脉IMT、斑块最大厚度、斑块面积及稳定斑块的积极作用。
- 脑梗死,进展性 /
- 颈动脉粥样硬化 /
- 阿托伐他汀 /
- 氯吡格雷
Abstract: Objective:To observe the clinical efficacy of the atorvastatin combined with clopidogrel and aspirin in the treatment of carotid arterial sclerosis in patients with progressive cerebral infarction.Methods:Fifty-five progressive cerebral infarction patients with carotid arterial sclerosis were randomly divided into the control group and observation group(28 cases each group).The control group were treated with simvastatin(20 mg/d) combined with aspirin(300 mg/d), once a day by oral before sleeping.The observation group were treated with aspirin(100 mg/d) combined with atorvastatin(40 mg/d) and clopidogrel(75 mg/d), once a day by oral before sleeping.Two groups were treated for 6 months.The carotid intima-media thickness(IMT), maximal thickness of atheromatous plaque, and area and number of plaque were observed using Doppler ultrasound before and after treatment.Results:The carotid IMT, maximal thickness of atheromatous plaque, and area of plaque in two groups decreased significantly after treatment(P<0.01), the differences of whose were statistically significant(P<0.05 to P<0.01).After treatment, the number of unstable plaque and stable plaque in control group was almost unchange.15 patches of unstable plaque and 9 patches of stable plaque in observation group decreased, and the differences of whose were statistically significant(P<0.01).Conclusions:The treatment of carotid arterial sclerosis in patients with progressive cerebral infarction with atorvastatin combined with clopidogrel and aspirin can reduce the carotid IMT, maximal thickness and area of plaque, and play a positive role in stabilizing therosclerotic plaque.
- cerebral infarction, progresseive /
- carotid arterial sclerosis /
- atorvastatin /
- clopidogrel

[1]	ROMERO JR,WOLF PA.Epidemiology of stroke:legacy of the framingham heart study[J].Clob Heart,2013,8(1):67.
[2]	SANDHU RK,MC ALISTER FA.Stroke prevention for patients with atrial fibrillation:improving but not perfect yet[J].Heart,doi:10.1136/heartjhl-2013-303656.
[3]	郭秀芳.波立维联合拜阿斯匹林治疗颈内动脉系统进展性脑梗死的临床观察[J].河北医药,2013,35(8):1161.
[4]	陆再应,钟南山.内科学[M].7版.北京:人民卫生出版社,2008.
[5]	马莉,张苏明.进展性脑卒中的研究进展[J].卒中与神经疾病,2006,13(3):190.
[6]	BOTS ML,HOES AW,KOUDSTAAL PJ,et al.Common carotid intima-media thickness and risk of stroke and myocardial infarction:the Rotterdam Study[J].Circulation,1997,91(5):1432.
[7]	CHAMBLESS LE,FOLSOM A,CLEGG LX,et al.Carotid wall thickness is predictive of incident clinical stroke:the Atherosclerosis Risk in Communities(ARIC) study[J].Am J Epidemiol,2000,151(5):478.
[8]	王玮.进展性脑卒中危险因素的临床分析[J].中国老年学杂志,2013,33(23):5811.
[9]	CHEN GJ,YANG MS.The effects of calcium channel blockers in the prevention of stroke in adult with hypertension:a meta-analysis of data from 273,543 participants in 31 randomized controlled trials[J].PloS One,2013,8(3):e57854.
[10]	胡文海.氯吡格雷联合肠溶阿司匹林治疗进展性脑梗死的疗效观察[J].蚌埠医学院学报,2014,39(5):633.
[11]	向平.氯吡格雷联合阿司匹林治疗进展性脑卒中的临床效果观察[J].现代诊断与治疗,2012,23(8):1278.

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阿托伐他汀联合氯吡格雷及拜阿司匹林对进展性脑梗死患者颈动脉粥样硬化的疗效评价

作者简介: 夏永梅(1972-),女,硕士,副主任医师.

Effect of the atorvastatin combined with clopidogrel and aspirin in the treatment of carotid arterial sclerosis in patients with progressive cerebral infarction

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阿托伐他汀联合氯吡格雷及拜阿司匹林对进展性脑梗死患者颈动脉粥样硬化的疗效评价

作者简介: 夏永梅(1972-),女,硕士,副主任医师.

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Effect of the atorvastatin combined with clopidogrel and aspirin in the treatment of carotid arterial sclerosis in patients with progressive cerebral infarction

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阿托伐他汀联合氯吡格雷及拜阿司匹林对进展性脑梗死患者颈动脉粥样硬化的疗效评价

作者简介: 夏永梅(1972-),女,硕士,副主任医师.

Effect of the atorvastatin combined with clopidogrel and aspirin in the treatment of carotid arterial sclerosis in patients with progressive cerebral infarction

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阿托伐他汀联合氯吡格雷及拜阿司匹林对进展性脑梗死患者颈动脉粥样硬化的疗效评价

作者简介: 夏永梅(1972-),女,硕士,副主任医师.

English Abstract

Effect of the atorvastatin combined with clopidogrel and aspirin in the treatment of carotid arterial sclerosis in patients with progressive cerebral infarction

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