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静脉溶栓前后应用瑞舒伐他汀对急性脑梗死患者的疗效与安全性比较
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| 篇名： | 静脉溶栓前后应用瑞舒伐他汀对急性脑梗死患者的疗效与安全性比较 |
| TITLE： | |
| 摘要： | 目的：比较静脉溶栓前后应用瑞舒伐他汀对急性脑梗死患者的疗效和安全性。方法：选取海南省人民医院2014年1月－2016年10月收治的行静脉溶栓的急性脑梗死患者共90例，以随机数字表法分为溶栓前组（45例）和溶栓后组（45例），分别在静脉溶栓前后24 h内开始给予瑞舒伐他汀（10 mg，qd）口服，用药8周。比较两组患者预后良好率，治疗前后NIHSS评分、ADL-Barthel指数评分、实验室指标[高迁移率族蛋白1（HMGB1）、基质金属蛋白酶9（MMP-9）、白介素17（IL-17）]水平、颅内出血发生率及不良反应发生情况。结果：溶栓前组患者溶栓后第1、8周的预后良好率均显著高于溶栓后组；治疗后两组患者NIHSS评分、ADL-Barthel指数评分与HMGB1、MMP-9及IL-17水平均显著优于治疗前，且溶栓前组各指标显著优于溶栓后组，差异均有统计学意义（P＜0.05）。两组患者颅内出血发生率比较，差异无统计学意义（P＞0.05），且无明显不良反应发生。结论：相较于静脉溶栓后给药，溶栓前开始给予瑞舒伐他汀可显著改善急性脑梗死患者的远期预后，促进其神经功能和日常生活质量恢复，同时降低HMGB1、MMP-9及IL-17水平，且未导致颅内出血风险增加，安全性较好。 |
| ABSTRACT： | OBJECTIVE： To compare therapecttic efficacy and safety of rosuvastation for patients with acute cerebral infarction （ACI） before and after the application of intravenous thrombolysis. METHODS： A total of 90 ACI patients receiving intravenous thrombolysis selected from Hainan Provincial People’s Hospital during Jan. 2014-Oct. 2016 were divided into pre-thrombolytic group （45 cases） and post-thrombolytic group （45 cases） according to random number table. Both were given rosuvastation （10 mg，qd） orally within 24 h before and after intravenous thrombolysis for 8 weeks. The rate of excellent prognosis were compared between 2 groups， and NIHSS score， ADL-Barthel index score， the levels of laboratory indexes （HMGB1， MMP-9， IL-17）， the incidence of intracranial hemorrhage and the occurrence of ADR were compared before and after treatment. RESULTS： The rate of excellent prognosis in pre-thrombolytic group one and eight weeks after thrombolysis was significantly higher than post-thrombolytic group. NIHSS score， ADL-Barthel index score， the levels of HMGB1， MMP-9 and IL-17 in 2 groups after treatment were significantly better than before treatment； the pre-thrombolytic group were significantly better than the post-thrombolytic group， with statistical significance （P＜0.05）. There was no significant difference in the incidence of intracranial hemorrhage between 2 groups（P＞0.05）， and no obvious ADR was found. CONCLUSIONS： Compared with post-thrombolytic medication， rosuvastation used before intravenous thrombolysis can significantly improve long-term prognosis， promote the recovery of neurological function and quality of daily life and reduce the levels of HMGB1， MMP-9 and IL-17， but does not increase the risk of intracranial hemorrhage with good safety. |
| 期刊： | 2018年第29卷第2期 |
| 作者： | 张茂，吴瑜，陈南耀，陈丽丽 |
| AUTHORS： | ZHANG Mao，WU Yu，CHEN Nanyao，CHEN Lili |
| 关键字： | 瑞舒伐他汀；静脉溶栓；急性脑梗死；疗效；安全性 |
| KEYWORDS： | Rosuvastation； Intravenous thrombolysis； Acute cerebral infarction； Therapeutic efficacy； Safety |
| 阅读数： | 353 次 |
| 本月下载数： | 3 次 |
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