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目的观察阿伐他汀联合阿司匹林治疗动脉粥样硬化的临床效果。方法选取医院收治的颈动脉粥样硬化患者120例为研究对象,随机分为A组、B组、C组,每组40例。A组采用阿司匹林治疗,B组采用阿伐他汀治疗,C组采用阿司匹林+阿伐他汀治疗。观察3组患者治疗前后血液黏度变化、血脂水平、IMT及CRP水平变化和不良反应发生情况。结果 3组患者治疗12个月后,A、C组血液黏度增高率均较治疗前下降(P<0.05);B组血液黏度增高率下降不明显(P>0.05)。A、C组治疗后的血液黏度增高率下降程度优于B组,差异有统计学意义(P<0.05)。B、C组TC、TG、LDL均明显降低,HDL明显升高(P<0.05);A组TC、TG、LDL也有所降低,HDL有所升高,但变化无统计学意义(P>0.05)。治疗后B、C组TC、TG、LDL、HDL的变化程度优于A组,差异有统计学意义(P<0.05)。治疗后,3组患者的IMT及CRP均较治疗前明显降低,差异有统计学意义(P<0.05),且C组患者的降低程度>A、B组(P<0.05)。A组出现腹胀1例,B组出现缺血性脑卒中6例、丙氨酸氨基转移酶轻度升高2例,治疗后自行好转。C组未见不良反应发生。结论阿伐他汀联合阿司匹林通过降低LDL等,可稳定、逆转颈动脉粥样硬化斑块,值得临床推广应用。
Objective To observe the clinical effect of atorvastatin combined with aspirin in the treatment of atherosclerosis. Methods A total of 120 patients with carotid atherosclerosis admitted to hospital were enrolled in this study. Patients were randomly divided into A group, B group and C group, 40 cases in each group. A group treated with aspirin, B group treated with atorvastatin, C group treated with aspirin + atorvastatin. Changes in blood viscosity, blood lipid levels, IMT and CRP levels and adverse reactions were observed before and after treatment in 3 groups. Results After 12 months treatment, the increase rate of blood viscosity in groups A and C was lower than that before treatment (P <0.05). The increase rate of blood viscosity in group B was not significantly decreased (P> 0.05). The decreasing rate of increase rate of blood viscosity in group A and group C was better than that in group B, the difference was statistically significant (P <0.05). The levels of TC, TG and LDL in group B and C were significantly lower than those in group C (P <0.05), while the levels of TC, TG and LDL in group A were also decreased, but the levels of HDL were increased, but the changes were not statistically significant (P> 0.05 ). After treatment, the changes of TC, TG, LDL and HDL in group B and C were better than those in group A, the difference was statistically significant (P <0.05). After treatment, the IMT and CRP in three groups were significantly lower than those before treatment (P <0.05), and the reduction in group C was> A and B (P <0.05). A group of abdominal distension occurred in 1 case, B group had ischemic stroke in 6 cases, alanine aminotransferase slightly elevated in 2 cases, improved after treatment. C group no adverse reactions occurred. Conclusions Atorvastatin combined with aspirin can stabilize and reverse the carotid atherosclerotic plaque by reducing LDL, which is worthy of clinical application.