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目的探讨普罗布考联合阿托伐他汀对颈动脉粥样硬化斑块的影响。方法对89例确诊颈动脉斑块的脑梗死患者随机分成试验组(n=47)和对照组(n=42),对照组行常规治疗(阿司匹林100mg,po,qd;阿托伐他汀20mg,po,qd),试验组在常规治疗的基础上,加服普罗布考(250mg,po,bid),两组均给药6个月,观察用药前后患者血脂总胆固醇(TC),甘油三酯(TG),低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C)、C反应蛋白(CRP)变化及颈动脉超声斑块声学密度的变化。结果治疗6个月,试验组、对照组治疗前后TC、TG、LDL-C及CRP的降低均有显著差异,且试验组显著低于对照组;试验组、对照组HDL-C较治疗前有显著提高,同时试验组显著高于对照组;试验组、对照组低回声斑块声学密度的背向散射积分值(IBS)较治疗前均显著提高,且试验组显著高于对照组。结论普罗布考联合阿托伐他汀可以显著降低脑梗死患者血清C反应蛋白、血脂,改善低回声斑块的组织学构成,增加颈动脉粥样硬化斑块的稳定性。
Objective To investigate the effect of probucol combined with atorvastatin on carotid atherosclerotic plaque. Methods Eighty-nine patients with cerebral infarction diagnosed with carotid artery plaque were randomly divided into experimental group (n = 47) and control group (n = 42), and the control group received conventional therapy (aspirin 100 mg, po, qd, atorvastatin 20 mg, po, qd). The experimental group was given probucol (250mg, po, bid) on the basis of routine treatment. Both groups were administered for 6 months. Before and after treatment, the levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), C-reactive protein (CRP) and carotid ultrasonic plaque acoustic density. Results After treatment for 6 months, the levels of TC, TG, LDL-C and CRP in the experimental group and the control group were significantly different, and the experimental group was significantly lower than the control group; HDL-C in the experimental group and the control group (P <0.05). The backscatter integral (IBS) of acoustic densities of hypoechoic plaques in test group and control group were significantly higher than those before treatment, and the experimental group was significantly higher than the control group. Conclusions Probucol combined with atorvastatin can significantly reduce serum C-reactive protein, lipids, improve the hypoechoic plaque histology and increase the stability of carotid atherosclerotic plaques in patients with cerebral infarction.