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[摘要]
目的 探讨不同剂量阿替普酶联合瑞舒伐他汀治疗急性缺血性脑卒中的疗效及安全性。方法 收取2010年1月至2015年12月于西电集团医院就诊的急性缺血性脑卒中患者82例作为研究对象,采用随机数字表法将其分为观察组与对照组各41例,观察组给予标准剂量阿替普酶(0.9 mg/kg)联合瑞舒伐他汀治疗,对照组给予低剂量阿替普酶(0.6 mg/kg)联合瑞舒伐他汀治疗。对两组患者治疗前后神经系统功能损伤、血脂变化情况、临床疗效、患者恢复情况及不良反应进行考察。结果 治疗后两组患者NIHSS评分及CSS评分均有所下降,与治疗前相比差异有统计学意义(P<0.05)。同时间点两组间差异不显著;治疗后两组患者总胆固醇(TC)及低密度脂蛋白(LDL)明显下降,差异较治疗前有统计学意义(P<0.05),观察组明显低于对照组,差异有统计学意义(P<0.05)。观察组总有效率与对照组比较差异无显著性。治疗后两组MRS评分均较治疗前下降,且随时间逐渐降低,差异有统计学意义(P<0.05)。观察组治疗后MRS评分低于对照组,自治疗后14d开始有统计学差异(P<0.05)。两组不良反应发生率比较差异无显著性。结论 标准剂量阿替普酶联合瑞舒伐他汀与小剂量阿替普酶相比疗效及安全性相当,但对于改善患者血脂水平及恢复情况更具优势,因此值得临床推广应用。
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[Abstract]
Objective To investigate the efficacy and safety of different doses of atorvastatin combined with rosuvastatin in the treatment of acute ischemic stroke. Methods Totally 82 patients with acute ischemic stroke accepted in Xi'an XD Group Hospital from January 2010 to February 2015 were selected and randomly divided into observation group and control group with 41 cases in each group. Patients in observation group were given standard dose of rt-PA (0.9 mg/kg) combined with rosuvastatin, and patients in control group were given low dose of rt-PA (0.6 mg/kg) combined with rosuvastatin. Nervous system injury, blood lipid before and after treatment, clinical effect, recovery, and adverse reactions of two groups were observed and compared. Results NIHSS and CSS scores of two groups after treatment were obviously lower than those before treatment with statistically significance (P<0.05), but difference between two groups of same time had no statistical significance. TC and LDL were decreasing after treatment, which had obvious difference compared to those before treatment. And observation group was lower than control group (P<0.05). Total efficacy of two groups had no difference. MRS scores of two groups were decreased with time, and MRS score of observation group was lower than that of control group with statistically difference after 14 d treatment (P<0.05). Adverse reaction rate of two groups had no statistical difference. Conclusion Different doses of rt-PA combined with rosuvasdtatin have similar effect and safety, but standard dose has better blood lipid level and recovery, which is worth clinical application.
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