摘要
目的探讨阿托伐他汀联合阿司匹林治疗脑梗死后偏瘫患者的效果。方法采用前瞻性研究。选取2022年9月至2024年12月淮南新华医疗集团新华医院收治的62例脑梗死偏瘫患者,采用随机数字表法分为对照组(n=31,采用常规治疗+阿托伐他汀治疗)和观察组(n=31,采用常规治疗+阿托伐他汀+阿司匹林治疗)。对照组和观察组患者均接受治疗3个月。比较对照组和观察组患者治疗前后血脂水平[低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)]、生活自理能力(Barthel指数)、精神状态[简易精神状态检查量表(MMSE)]、肢体运动功能、血小板功能相关指标[血小板激活复合物-1(PAC-1)、血小板膜表面P选择素(CD62p)]水平及不良反应发生情况。结果治疗后观察组患者的LDL-C水平低于对照组[(2.57±0.38)mmol/L vs(2.86±0.37)mmol/L]、TC[(3.18±0.75)mmol/L vs(3.67±0.71)mmol/L]、TG[(1.28±0.23)mmol/L vs(1.43±0.22)mmol/L],差异有统计学意义(t=3.044、2.642、2.624,均P<0.05)。治疗后观察组患者的Barthel指数评分和MMSE评分均高于对照组[(75.35±5.67)分vs(70.12±5.11)分,(24.35±2.87)分vs(21.35±2.81)分],差异有统计学意义(t=3.815、4.159,均P<0.05)。治疗后观察组患者的上肢运动能力和下肢运动能力评分高于对照组[(45.35±4.67)分vs(41.38±4.61)分,(24.32±2.12)分vs(21.35±2.13)分],差异有统计学意义(t=3.368、5.503,均P<0.05)。治疗后观察组患者的PAC-1、CD62p水平低于对照组[(6.78±1.35)%vs(8.54±1.32)%,(4.68±1.22)%vs(5.38±1.23)%],差异有统计学意义(t=5.190、2.250,均P<0.05)。观察组和对照组患者的不良反应发生率[9.69%(3/31)vs 3.23%(1/31)]比较,差异无统计学意义(χ^(2)=0.267,P=0.605)。结论阿托伐他汀联合阿司匹林能够改善脑梗死后偏瘫患者的血脂水平、精神状态、血小板功能,提高生活自理能力、肢体运动功能,且安全性较好。
Objective To explore the efficacy of atorvastatin combined with aspirin in the treatment of patients with hemiplegia after cerebral infarction.Methods This was a prospective study.A total of 62 patients with hemiplegia after cerebral infarction treated in Huainan Xinhua Medical Group Xinhua Hospital from September 2022 to December 2024 were enrolled in the study and randomly divided into the control group with 31 cases and the observation group with 31 cases.The control group was treated with conventional therapy plus atorvastatin,and the observation group was given conventional therapy plus atorvastatin and aspirin.Both groups were treated for 3 months.The levels of blood lipids(low density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triglyceride(TG)),self-care ability(Barthel Index(BI)),mental state indexes(Mini-Mental State Examination(MMSE)scores),limb motor ability,the levels of platelet function-related indexes(platelet activating complex-1(PAC-1),platelet membrane surface P-selectin(CD62p))before and after treatment,and the incidence of adverse reactions were compared between the two groups.Results The levels of LDL-C,TC and TG of the observation group were lower than those of the control group after treatment((2.57±0.38)mmol/L vs(2.86±0.37)mmol/L;(3.18±0.75)mmol/L vs(3.67±0.71)mmol/L;(1.28±0.23)mmol/L vs(1.43±0.22)mmol/L),and there were statistically significant differences(t=3.044,2.642,2.624,all P<0.05).The BI score and MMSE score of the observation group were higher than those of the control group((75.35±5.67)points vs(70.12±5.11)points;(24.35±2.87)points vs(21.35±2.81)points),and there were statistically significant differences(t=3.815,4.159,both P<0.05).The scores of upper limb motor ability and lower limb motor ability of the observation group were higher than those of the control group after treatment((45.35±4.67)points vs(41.38±4.61)points;(24.32±2.12)points vs(21.35±2.13)points),and there were statistically significant differences(t=3.368,5.503,both P<0.05).The levels of PAC-1 and CD62p of the observation group were lower than those of the control group after treatment((6.78±1.35)%vs(8.54±1.32)%;(4.68±1.22)%vs(5.38±1.23)%),and there were statistically significant differences(t=5.190,2.250,both P<0.05).The incidence of adverse reactions was 9.69%(3/31)in the observation group and 3.23%(1/31)in the control group,with no statistically significant difference(χ^(2)=0.267,P=0.605).Conclusion Atorvastatin combined with aspirin can improve the blood lipids,mental state and platelet function,and enhance the self-care ability and limb motor function of the patients with hemiplegia after cerebral infarction,demonstrating a favorable safety profile.
作者
柏永春
张召丰
李洁
BAI Yongchun;ZHANG Zhaofeng;LI Jie(Department of Rehabilitation Medicine,Huainan Xinhua Medical Group Xinhua Hospital,Huainan 232052,China)
出处
《中国药物应用与监测》
2025年第9期1497-1501,共5页
Chinese Journal of Drug Application and Monitoring
基金
2022年安徽省卫生健康科研项目(AHWJ2022c013)。
