普罗布考联合瑞舒伐他汀对脑梗死合并糖尿病患者颈动脉粥样硬化斑块、血脂及炎症因子的影响
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(唐山市人民医院神经内科,河北省唐山市 063000)

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董晓柳,硕士,主治医师,研究方向为普罗布考对老年动脉硬化患者基因表达及认知功能的研究,E-mail为28710694@qq.com。朱丽霞,副主任护师,研究方向为运动疗法对脑梗死偏瘫步态的影响,E-mail为12128012@qq.com。徐士军,硕士,副主任医师,研究方向为药物对老年患者踝肱指数的影响,E-mail为xushijun00000@163.com。

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Influence of Probucol Combined with Rosuvastatin on Carotid Atherosclerotic Plaque, Blood Lipid, Inflammatory Factor in Patients with Cerebral Infarction Complicated with Diabetes Mellitus
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Department of Internal Neurology, The people's Hospital of Tangshan City, Tangshan, Hebei 063000,China)

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    摘要:

    目的 探讨普罗布考联合瑞舒伐他汀对脑梗死合并糖尿病患者颈动脉粥样硬化斑块、血脂、炎症因子的影响。方法 选取脑梗死合并糖尿病患者146例,采用随机数字表法分为两组,73例患者采用瑞舒伐他汀治疗为对照组,73例患者采用普罗布考联合瑞舒伐他汀治疗为观察组,比较两组患者颈动脉超声检查结果、血脂指标变化情况、炎症因子变化情况、S100β与NIHSS评分变化情况及不良反应发生情况。结果 治疗后,两组患者颈动脉内膜中膜厚度、颈动脉内膜斑块面积、易损斑块检出率、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高敏C反应蛋白、白细胞介素6、肿瘤坏死因子α、S100β、尿微量白蛋白、NIHSS评分均显著降低,高密度脂蛋白胆固醇均显著增加。观察组患者颈动脉内膜中膜厚度、颈动脉内膜斑块面积、易损斑块检出率、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高敏C反应蛋白、白细胞介素6、肿瘤坏死因子α、S100β、尿微量白蛋白、NIHSS评分均明显低于对照组,高密度脂蛋白胆固醇明显高于对照组,差异均有统计学意义(P<0.05)。观察组患者不良反应(肝肾功能异常、头晕头痛、皮疹、肌痛、恶心呕吐、胃肠道反应)发生率与对照组差异无统计学意义(P>0.05)。结论 普罗布考联合瑞舒伐他汀是治疗脑梗死合并糖尿病的有效方案,能减小颈动脉粥样硬化斑块,改善血脂状况,降低炎症因子水平,具有较高安全性。

    Abstract:

    Aim To investigate influence of probucol combined with rosuvastatin on carotid atherosclerotic plaque, blood lipid, inflammatory factor in patients with cerebral infarction complicated with diabetes mellitus. Methods146 patients with cerebral infarction complicated with diabetes mellitus were selected in hospital from December 2011 to December 2013, who were randomly divided into two groups. 73 patients were treated with rosuvastatin as control group. 73 patients were treated with probucol combined with rosuvastatin as observation group. Carotid artery ultrasound results, serum lipid index changes, inflammatory factor changes, S100β and NIHSS score changes, adverse reactions were compared between two groups. Results After treatment, carotid artery intima-media thickness(CAIMT), carotid intimal plaque area, detection rate of vulnerable plaque, total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDLC), high sensitivity C reactive protein(hs-CRP), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), S100β, urine micro albumin, NIHSS score reduced significantly in two groups, while high density lipoprotein cholesterol(HDLC) increased significantly. CAIMT, carotid intimal plaque area, detection rate of vulnerable plaque, TC, TG, LDLC, hs-CRP, IL-6, TNF-α, S100β, urine micro albumin, NIHSS score in observation group were significantly lower than control group, while HDLC was significantly higher than control group. Differences were statistically significant(P<0.05). There were no significant difference between observation group and control group in incidence of adverse reactions(abnormal liver and kidney function, dizziness headache, rash, myalgia, nausea and vomiting, gastrointestinaltract reaction, P>0.05). Conclusion Probucol combined with rosuvastatin is an effective method in treatment of cerebral infarction complicated with diabetes mellitus, which can reduce carotid atherosclerotic plaque and improve blood lipid status, decrease inflammatory factor level and has high safety.

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董晓柳,朱丽霞,徐士军.普罗布考联合瑞舒伐他汀对脑梗死合并糖尿病患者颈动脉粥样硬化斑块、血脂及炎症因子的影响[J].中国动脉硬化杂志,2016,24(2):177~181.

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  • 收稿日期:2015-03-02
  • 最后修改日期:2015-05-14
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  • 在线发布日期: 2016-06-30