Zhongguo cuzhong zazhi (Oct 2024)
普罗布考联合阿托伐他汀钙治疗急性脑梗死的疗效Effects of Probucol Combined with Atorvastatin Calcium in the Treatment of Acute Cerebral Infarction
Abstract
目的 评估普罗布考与阿托伐他汀钙联合治疗急性脑梗死（acute cerebral infarction，ACI）的疗效，以提供ACI的治疗参考方案。 方法 回顾性收集2018年1月—2023年9月在重庆市急救医疗中心就诊，发病24 h内住院的ACI患者资料。纳入患者需满足：接受了阿托伐他汀钙（20 mg，每晚1次）单药或联用普罗布考（0.5 mg，每日2次）调节血脂治疗，且治疗周期为3个月以上。根据是否联用普罗布考分为联合治疗组和对照组，比较两组治疗后神经功能（使用NIHSS评估）、神经功能结局（使用mRS评估）、生活能力（使用Barthel指数评估）以及血脂水平的差异。 结果 研究共入组102例患者，其中联合治疗组56例，对照组46例。两组的基线资料差异无统计学意义。治疗后14 d两组的NIHSS评分和血脂水平、治疗3个月后的血脂水平均较本组治疗前显著改善（均P<0.001）。治疗14 d时，联合治疗组的NIHSS评分（P=0.031）、TC（P=0.005）和LDL-C（P=0.044）水平低于对照组，Barthel指数（P=0.004）高于对照组，差异有统计学意义。治疗3个月时，联合治疗组的mRS评分（P＜0.001）、TC（P＜0.001）、TG（P=0.002）和LDL-C（P＜0.001）水平低于对照组，Barthel指数高于对照组（P＜0.001），差异有统计学意义。随访3个月期间联合治疗组的脑梗死复发率为0，对照组为2.17%，但差异无统计学意义（P=0.268）。 结论 普罗布考联合阿托伐他汀钙治疗ACI急性期患者，相较于单独使用阿托伐他汀钙，具有更佳的临床疗效，能有效降低血脂水平并改善患者的神经功能及生活能力。 Abstract: Objective To evaluate the effects of probucol combined with atorvastatin calcium in the treatment of acute cerebral infarction (ACI), with the aim of providing a therapeutic reference for ACI. Methods Data of ACI patients hospitalized within 24 h of symptom onset at Chongqing Emergency Medical Center from January 2018 to September 2023 were retrospectively collected. Patients included in the study met specific criteria, which included receiving lipid-regulating therapy with atorvastatin calcium (20 mg, qn) monotherapy or combined with probucol (0.5 mg, bid) for a treatment duration exceeding 3 months. Patients were divided into the combined treatment group and the control group according to whether probucol was combined or not. The study compared differences in neurological function (measured by the NIHSS), neurological outcome (measured by the mRS), life ability [measured by the Barthel index], and lipid levels (including TC, TG, HDL-C and LDL-C) between the two groups. Results A total of 102 patients were enrolled in the study, including 56 in the combined treatment group and 46 in the control group. There was no statistically significant difference in baseline data between the two groups. The NIHSS scores and lipid levels in both groups at 14 days post-treatment, as well as the lipid levels after 3 months of treatment, showed significant improvement compared to baseline controls (P<0.001). After 14 days of treatment, the NIHSS score (P=0.031), TC (P=0.005) and LDL-C (P=0.044) levels of the combined treatment group were lower than those of the control group, while the Barthel index score (P=0.004) was higher than that of the control group. The difference was statistically significant. After 3 months of treatment, the mRS score (P<0.001), TC (P<0.001), TG (P=0.002) and LDL-C (P<0.001) levels of the combined treatment group were lower than those of the control group, while the Barthel index score (P<0.001) was higher than that of the control group. The difference was statistically significant. The recurrence rate of cerebral infarction during the 3 months follow-up period was 0 in the combined treatment group and 2.17% in the control group. The difference was not statistically significant (P= 0.268). Conclusions The combination of probucol and atorvastatin calcium in treating patients in the acute phase of ACI demonstrated superior clinical efficacy compared to atorvastatin calcium alone. This combination effectively reduced lipid levels and improved neurological function and ability to live.
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