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双重抗血小板治疗联合不同剂量他汀类药物治疗急性脑梗死合并微出血的临床研究

Clinical study of double anti-platelet therapy combined with different doses of statin in the treatment of acute cerebral infarction complicated with microhemorrhage.

作者信息

Zhou Ting, Mei Junhua, Hou Min

机构信息

Department of Neurology, People's Hospital of Dongxihu District Wuhan 430040, China.

Department of Neurology, The First Hospital of Wuhan City Wuhan 430033, China.

出版信息

Am J Transl Res. 2021 Oct 15;13(10):12043-12050. eCollection 2021.

Abstract

OBJECTIVE

To assess the clinical effect and safety of double anti-platelet therapy combined with different doses of statins for acute cerebral infarction complicated with microhemorrhage.

METHODS

A total of 312 patients who had acute cerebral infarction complicated with microhemorrhage in our hospital were randomly allocated into two groups: the experimental group (n=164) and group for control (n=148). Those in the group for experiment received dual antiplatelet rosuvastatin tablets (20 mg QN), while the control group received dual antiplatelet rosuvastatin tablets (10 mg QN). After 30 days of treatment, blood biochemistry and brain magnetic resonance imaging were performed to record the serum lipid levels, liver transaminase, inflammatory and oxidative stress indicators and other biochemical indicators as well as the number of cerebral microhemorrhage foci.

RESULTS

Serum lipids in both groups after intervention were decreased compared to those without intervention (P < 0.05). Furthermore, after receiving the intervention, the HCY and inflammatory indicators (such as hs-CRP) of the two groups were improved compared to before intervention (P < 0.05). The safety index (Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Creatine kinase (CK), creatinine (Cr)) had no statistically significant difference than those without intervention in the two groups (P > 0.05).

CONCLUSION

Rosuvastatin can effectively regulate blood lipids and Hcy levels in patients with acute cerebral infarction and microbleeds, and it can reduce blood lipids and inflammation; furthermore, high dose rosuvastatin has better improvement effects and higher safety in a shorter period time.

摘要

目的

评估双重抗血小板治疗联合不同剂量他汀类药物治疗急性脑梗死合并微出血的临床疗效及安全性。

方法

选取我院312例急性脑梗死合并微出血患者,随机分为两组:试验组(n = 164)和对照组(n = 148)。试验组患者接受双重抗血小板治疗联合瑞舒伐他汀钙片(20 mg每晚一次),对照组患者接受双重抗血小板治疗联合瑞舒伐他汀钙片(10 mg每晚一次)。治疗30天后,进行血液生化检查及脑磁共振成像,记录血脂水平、肝转氨酶、炎症及氧化应激指标等生化指标以及脑微出血灶数量。

结果

与未干预时相比,两组干预后的血脂均降低(P < 0.05)。此外,两组干预后的同型半胱氨酸(HCY)及炎症指标(如超敏C反应蛋白(hs-CRP))较干预前均有所改善(P < 0.05)。两组的安全指标(天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、肌酸激酶(CK)、肌酐(Cr))与未干预时相比无统计学差异(P > 0.05)。

结论

瑞舒伐他汀可有效调节急性脑梗死合并微出血患者的血脂及同型半胱氨酸水平,降低血脂及炎症;此外,大剂量瑞舒伐他汀在较短时间内具有更好的改善效果及更高的安全性。

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