摘要
目的评估动脉粥样硬化性脑梗死(ACI)二级预防病人联用不同剂量阿托伐他汀和强肝胶囊的降脂效果及其安全性。方法选择2017年8月至2018年1月于冀中能源峰峰集团有限公司总医院神经内科住院的急性脑梗死病人180例,病因分型为TOAST大动脉粥样硬化型或小动脉闭塞型,合并高脂血症,既往无类似发作。入选病人按随机数字表法分为10 mg对照组、20 mg对照组、40 mg对照组和10 mg观察组、20 mg观察组、40 mg观察组,均给予对应剂量的阿托伐他汀钙片,口服,每晚1次;观察组额外加用强肝胶囊2 g,口服,每天2次;疗程均为3个月。测定治疗前后病人血脂[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL⁃C)]和谷丙转氨酶(ALT)数值。析因分析比较用药种类、阿托伐他汀剂量对上述指标的影响。结果治疗后阿托伐他汀相同剂量组间比较:20 mg观察组TC水平显著低于20 mg对照组[(4.04±0.77)比(4.69±0.91)mmol/L,P<0.01],差异有统计学意义。关于LDL⁃C和ALT水平,10 mg观察组显著低于10 mg对照组[(2.98±0.49)比(3.34±0.42)mmol/L、(21.6±4.3)比(29.1±6.3)U/L];20 mg观察组显著低于20 mg对照组[(2.66±0.45)比(2.95±0.42)mmol/L、(25.2±4.6)比(32.4±6.1)U/L];40 mg观察组显著低于40 mg对照组[(2.41±0.48)比(2.70±0.47)mmol/L、(31.8±6.2)比(36.1±6.4)U/L];均差异有统计学意义(P<0.05)。析因分析显示,联用强肝胶囊与否对TC、LDL⁃C和ALT水平变化有显著影响(P<0.01)。结论ACI二级预防病人联用阿托伐他汀和强肝胶囊提高了降脂效果和安全性。
Objective To evaluate the lipid⁃lowering effect and safety of different doses of atorvastatin combined with Qianggan capsule in patients with secondary prevention of atherosclerotic cerebral infarction(ACI).Methods From August 2017 to January 2018,180 patients with acute cerebral infarction who were hospitalized in neurology department of General Hospital of Jizhong En⁃ergy Fengfeng Group Co.,Ltd.were selected.The etiology was classified as toast big atherosclerosis type or small artery occlusion type,with hyperlipidemia and no similar attack in the past.All patients were divided by random digital table method into 10 mg control group,20 mg control group,40 mg control group,10 mg observation group,20 mg observation group and 40 mg observation group and were treated with the corresponding dose of atorvastatin calcium tablets,oral,once a night,and patients in three obser⁃vation groups were additive treated with 2 g Qianggan capsule,orally,twice a day for 3 months.Levels of serum lipids[Triglycer⁃ide(TG),Total cholesterol(TC),low density lipoprotein cholesterol(LDL⁃C)]and alanine aminotransferase(ALT)were mea⁃sured before and after treatment.Effects of drug types and atorvastatin dose on the above indexes were analyzed by factorial analy⁃sis.Results TC level in 20 mg observation group was significantly lower than that in 20 mg control group[(4.04±0.77)vs.(4.69±0.91)mmol/L,P<0.01].The levels of LDL⁃C and ALT in 10 mg observation group were significantly lower than those in 10 mg control group[(2.98±0.49)vs.(3.34±0.420)mmol/L,(21.6±4.3)vs.(29.1±6.3)U/L,P<0.05],while those in 20 mg observation group was significantly lower than those in 20 mg control group[(2.66±0.45)vs.(2.95±0.42)mmol/L,(25.2±4.6)vs.(32.4±6.1)U/L,P<0.05],and these in 40 mg observation group was significantly lower than these in 40 mg control group[(2.41±0.48)vs.(2.70±0.47)mmol/L,(31.8±6.2)vs.(36.1±6.4)U/L,P<0.05].The factorial analysis results showed that combination atorvastatin with Qianggan capsule had significant influence on the changes of TC,LDL⁃C and ALT(P<0.01).Conclusion Atorvastatin com⁃bined with Qianggan capsule improves the lipid⁃lowering effect and safety in patients with ACI secondary prevention.
作者
郭明升
郭英杰
刘娟
郝艳爽
GUO Mingsheng;GUO Yingjie;LIU Juan;HAO Yanshuang(Department of Neurology,General Hospital of Jizhong Energy Fengfeng Group Co.,LTD.,Handan,Hebei 056200,China;Department of Clinical Laboratory of North Hospital District,General Hospital of Jizhong Energy Fengfeng Group Co.,LTD.,Handan,Hebei 056200,China;Department of Gastroenterology,General Hospital of Jizhong Energy Fengfeng Group Co.,LTD.,Handan,Hebei 056200,China)
出处
《安徽医药》
CAS
2020年第1期9-12,共4页
Anhui Medical and Pharmaceutical Journal
基金
河北省医学科学研究重点课题计划（20181744）
邯郸市科学技术研究与发展计划项目（1823208019ZC)
关键词
脑梗死
二级预防
降血脂药物
三酰甘油类
胆固醇酯类
胆固醇
HDL
阿托伐他汀
强肝胶囊
析因分析
Brain infarction
Secondary prevention
Hypolipidemic agents
Triglycerides
Cholesterol esters
Cholesterol,HDL
Atorvastatin
Qianggan capsule
Factorial analysis
