氨氯地平联合阿托伐他汀对老年急性缺血性卒中合并高血压患者的影响

目的:探讨氨氯地平联合不同剂量阿托伐他汀对老年急性缺血性卒中合并高血压患者血脂调控和神经功能的影响。方法:急性缺血性卒中合并高血压患者83例随机分为标准组42例和强化组41例。两组在常规治疗基础上加用苯磺酸氨氯地平片。在此基础上,标准组和强化组分别给予阿托伐他汀钙片20 mg/次和40 mg/次。对比两组治疗前后4周血压、血脂相关指标变化,以及治疗前后12周美国国立卫生卒中量表(NHISS)评分、改良Rankin量表(mRS)和巴氏量表(BI)评分。记录两组观察期内用药不良反应和脑血管事件复发情况。结果:治疗后4周,两组收缩压(SBP)和舒张压(DBP)均较治疗前显著下降(P<0.01);两组总胆固醇(TC)、甘油三脂(TG)和低密度脂蛋白胆固醇(LDL-C)水平较治疗前下降(P<0.01),其中TC和LDL-C水平强化组下降更为显著(P<0.05或P<0.01)。治疗后12周,两组NHISS、mRS评分下降,BI评分上升(P<0.05或P<0.01),且强化组NHISS、mRS评分改善显著优于标准组(P<0.05或P<0.01)。两组均无严重不良反应,脑血管事件复发率差异无统计学意义(P>0.05)。结论:针对老年急性缺血性卒中合并高血压患者,氨氯地平联合阿托伐他汀强化治疗较常规治疗调脂和改善神经功能效果更好。

Effect of amlodipine combined with different doses of atorvastatin on the regulation of blood lipids and neurological function in elderly patients with acute ischemic stroke complicated by hypertension

Objective:To explore the effect of amlodipine combined with different doses of atorvastatin on the regulation of blood lipids and neurological function in elderly patients with acute ischemic stroke complicated by hypertension.Methods:Eighty-three patients with acute ischemic stroke complicated by hypertension were randomly assigned into standard group (n =42 )and intensive group (n =41 ).Based on routine treatment,both groups were added Amlodipine Besylate Tablets.Additionally,standard group and in-tensive group were treated with Atorvastatin Calcium Tablets,20 mg and 40 mg per time respectively.The changes of blood pressure and lipid-related indexes before and 4 weeks after treatment as well as scores of National Institute of Health Stroke Scale (NIHSS),modified Rankin scale and Barthel index (BI)before and 12 weeks after treatment were all compared in two groups.The adverse reactions and recurrent conditions of cerebrovascular events were recorded in two groups in observation period.Results:Four weeks after treatment, both systolic blood pressure (SBP)and diastolic blood pressure (DBP)decreased significantly in two groups when compared with treatment before (P <0.01 ).When compared with treatment before,the levels of total cholesterol (TC),triglyceride (TG)and low density lipoprotein cholesterol (LDL-C)went down in two groups (P <0.01 ),in which the decreased range of TC and LDL-C was more significant in intensive group (P <0.05 or P <0.01 ).Twelve weeks after treatment,both NHISS and mRS scores in two groups reduced,while BI scores increased(P <0.05 or P <0.01 ).The improved degree of NHISS and mRS scores in intensive group was su-perior to that of standard group (P <0.05 or P <0.01 ).None of patients suffered from severe adverse reactions in two groups,and there was no statistical significance regarding the recurrence rate of cerebrovascular events (P >0.05 ).Conclusion:For elderly pa-tients with acute ischemic stroke complicated by hypertension,the intensive treatment of amlodipine combined with atorvastatin has bet-ter effects on regulation of blood lipids and improvement of neurological function when compared with routine treatment.