目的 观察瑞舒伐他汀联合普罗布考治疗老年脑梗死患者的临床疗效.方法 选择2016年9月—2017年10月河北省邢台市第三医院神经内科收治老年脑梗死患者98例作为研究对象,按照随机数字表法分为对照组与观察组,每组49例.2组患者均给予降血压、降血糖等基础治疗,对照组加用瑞舒伐他汀治疗;观察组则于对照组治疗基础上加用普罗布考治疗.分别于治疗前、治疗6个月后检测2组患者血脂、超敏C反应蛋白(hs-CRP)、血清氧化型低密度脂蛋白自身抗体(oxLDL-Ab)、血清基质金属蛋白酶9(MMP-9)、白细胞介素6(IL-6)及肿瘤坏死因子α(TNF-α)水平;采用超声检测2组患者治疗前、治疗6个月后颈动脉内膜中层厚度(IMT)和颈动脉内膜斑块面积,评价2组患者治疗前、后神经功能缺损状况.记录治疗期间不良反应.结果 治疗6个月后,2组患者三酰甘油(TG)、总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)水平较治疗前显著下降,高密度脂蛋白胆固醇(HDL-C)升高(对照组:t=10.058、8.211、14.906、-3.788,P<0.01,观察组:t=18.167、7.947、15.586、-3.551,P<0.01);且观察组TC、TG、LDL-C下降程度较对照组显著(t=4.430、-1.992、4.531,P<0.01).2组hs-CRP、MMP-9、TNF-α、IL-6水平较治疗前显著下降(对照组:t=20.593、6.255、11.930、6.879,观察组:t=12.366、16.960、14.389、18.333,P<0.01);且观察组下降程度较对照组显著(t=23.560,2.898,5.718,8.604,P<0.01).观察组oxLDL-Ab水平较治疗前显著下降(t=9.139,P<0.01),而对照组无明显变化(t=1.250,P﹥0.05).2组IMT、颈动脉内膜斑块面积、神经功能缺损评分较治疗前均显著下降(对照组:t=2.156、2.183、4.511),观察组:t=4.846、7.900、16.398,P<0.01);且观察组优于对照组(t=2.561、6.597、18.969,P均<0.01).2组治疗期间均未见明显不良反应.结论 采用瑞舒伐他汀联合普罗布考治疗老年期脑梗死疗效显著且无明显不良反应,值得推广.%Objective To investigate the clinical efficacy of rosuvastatin combined with probucol in the treatment of senile cerebral infarction. Methods Ninety-eight cases of elderly patients with cerebral infarction admitted to our hospital from Sept 2016 to Oct 2017 were divided into control group and observation group according to random number table method, each group was 49 cases. Two groups of patients were given anti-hypotensive blood pressure,anti-hypoglycemic and other basic treatment,in which the control group was treated with rosuvastatin on the basis of treatment;the observation group was treated with probucol on the basis of control group treatment. The levels of serum lipids,hs-CRP,oxLDL-Ab and MMP-9 in the two groups were measured before treatment and 6 months after treatment respectively. MMP 9,interleukin 6 (IL-6) and tumor nec-rosis factor α ( TNF-α) were measured before and after treatment for 6 months. The carotid intima media thickness Arterial plaque area, neurological deficit was evaluated in the two groups of patients before and after treatment. Recorded adverse reac-tions during treatment. Results After 6 months of treatment, the levels of three acyl glycerol ( TG) , total cholesterol ( TC) and low density lipoprotein cholesterol ( LDL-C) in the 2 groups were significantly lower than those before the treatment. The high density lipoprotein cholesterol (HDL-C) increased (the control group:t=10. 058, t=8. 211, t=4. 906, t= -3. 788;observation group:t=18. 167, t=7. 947, t=15. 586, t= -3. 551,P<0. 01). And the decrease degree of TC, TG and LDL-C in the observation group was significantly higher than that of the control group ( t=4. 430, t= -1. 992, t=4. 531, P<0. 01), and the level of hs-CRP, MMP-9, TNF-alpha and IL-6 decreased significantly in the 2 groups, more significantly in the observation group (t=23. 560, t=2. 898, t=5. 718, t=8. 604, P<0. 01), the level of oxLDL Ab in the observation group was significantly lower than that before the treatment (t=9. 139, P<0. 01), but there was no significant change in the control group (t=1. 251, P > 0. 05). 2 groups of IMT, carotid artery intima plaque area and nerve function defect scores were significantly lower than before treatment (control group:t=2. 156, t=2. 183, t=4. 511, observation group:t=4. 846, t=7. 900, t=16. 398, P<0. 05), and the observation group was superior to the control group (t=2. 561, t=6. 597, t=18. 969, all P<0. 01). There was no obvious adverse reaction during the treatment of the 2 groups. Conclusion The use of rosuvastatin combined with probucol in the treatment of senile cerebral infarction had significant effect and no significant ad-verse reactions,it is worth promoting.
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