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目的探讨银丹心脑通软胶囊联合瑞舒伐他汀钙和硫酸氢氯吡格雷对伴有2型糖尿病急性脑梗死患者血脂、颈动脉粥样硬化(CAS)斑块及神经功能恢复的影响。方法选择2013年5月—2015年1月于天津医院收治的伴有2型糖尿病脑梗死患者150例,经颈动脉彩色超声证实有颈动脉斑块。所选病例随机分为两组,每组75例。两组在基础病治疗基础上,对照组给予瑞舒伐他汀钙片10 mg/d(每日1次)及硫酸氢氯吡格雷75 mg/d(每日1次),口服;治疗组在对照组基础上给予银丹心脑通软胶囊每次3粒(0.4 g/粒),每日3次。两组均进行饮食控制,根据病情给予控制血压、血糖及其他基础疾病药物治疗。检测两组治疗前及治疗12个月后血脂水平;统计两组颈动脉斑块总数、测量斑块内膜-中层厚度(IMT)及判定斑块性质;于治疗前后对两组患者进行神经功能评分及疗效判定;统计两组终点事件发生情况。结果疗程结束后,两组血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)降低,高密度脂蛋白胆固醇(HDL-C)升高,但治疗组LDL-C较对照组明显降低(P<0.05);两组颈部IMT较治疗前明显降低,但治疗组斑块面积较对照组明显缩小(P<0.05);治疗组的神经功能评分较对照组明显减低(P<0.05);治疗组疗效显著优于对照组(P<0.01),治疗组药物不良反应发生率低于对照组(P<0.05)。结论银丹心脑通软胶囊联合瑞舒伐他汀钙和硫酸氢氯吡格雷治疗伴有2型糖尿病急性脑梗死患者的高脂血症及CAS斑块疗效显著。
Objective To investigate the effects of Yin Dan Xin Nao Tong Capsule combined with rosuvastatin calcium and clopidogrel on the blood lipid, carotid atherosclerosis (CAS) plaque and neurological function in patients with type 2 diabetes mellitus after acute cerebral infarction. Methods From May 2013 to January 2015 in Tianjin Hospital, 150 cases of type 2 diabetic patients with cerebral infarction were treated in Tianjin Hospital. Carotid plaques were confirmed by color ultrasound of carotid artery. Selected cases were randomly divided into two groups, each group of 75 cases. On the basis of basic disease treatment, the two groups were given rosuvastatin calcium 10 mg / d (once daily) and clopidogrel hydrogen sulfate 75 mg / d (once daily) On the basis of the control group, Yin Dan Xin Nao Tong soft capsules were given 3 capsules (0.4 g / capsule) three times a day. Two groups were diet control, according to the disease given to control blood pressure, blood sugar and other underlying diseases drug treatment. The levels of lipid in the two groups before and 12 months after treatment were measured. The total carotid plaques in both groups were measured, and the plaque intima-media thickness (IMT) and plaque quality were determined. Before and after treatment, the neurological function Score and efficacy of judgment; statistics of the occurrence of the end of the two events. Results After treatment, TC, LDL-C, TG and HDL-C of the two groups were increased, but LDL C was significantly lower than that of the control group (P <0.05). The IMT of the neck in the two groups was significantly lower than that before treatment, but the plaque area in the treatment group was significantly smaller than that in the control group (P <0.05); the neurological score in the treatment group was significantly higher than that in the control group (P <0.05). The curative effect in the treatment group was significantly better than that in the control group (P <0.01). The incidence of adverse drug reactions in the treatment group was lower than that in the control group (P <0.05). Conclusion Yindan Xinnaotong soft capsule combined with rosuvastatin calcium and clopidogrel hydrogen sulfate in patients with type 2 diabetes mellitus acute cerebral infarction patients with hyperlipidemia and CAS plaque significant effect.