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脂康颗粒联合不同剂量阿托伐他汀用于脑梗死二级预防效果观察及析因分析

Observation and Factorial Analysis of Zhikang Granule Combined with Different Doses of Atorvastatin in Secondary Prevention of Cerebral Infarction

DOI：

中文关键词: 脂康颗粒阿托伐他汀脑梗死二级预防析因分析

英文关键词:Zhikang granule Atorvastatin Cerebral infarction Secondary prevention Factorial analysis

基金项目:

作者	单位
陈梅^① 郭明升^②	①河北省冀中能源峰峰集团有限公司九龙矿医院（河北邯郸056200）；②河北省冀中能源峰峰集团有限公司总医院神经内科

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中文摘要:

摘要目的：评估脂康颗粒联合阿托伐他汀在动脉粥样硬化脑梗死二级预防中的效果。方法：180例患者随机分为对照组和观察组各90例，2组再随机分为三个亚组。对照组3个亚组分别每日顿服阿托伐他汀片10，20，40 mg；观察组3个亚组在对照组基础上加用脂康颗粒。两组均连续治疗6个月。测定治疗前、治疗3个月、治疗6个月时各组患者的血脂指标（TG、TC、LDL C）和ALT、动脉内中膜厚度（IMT）；使用析因分析比较用药种类、阿托伐他汀剂量、治疗时间对上述指标的影响。结果：治疗3个月后，两组及各亚组TG、TC、LDL C等血脂指标均较治疗前明显下降（P<0.05），ALT较前明显升高（P<0.05）；观察组及各亚组TG、TC、LDL C水平明显低于对照组及各相应亚组（P<0.05）；两组40 mg亚组、20 mg亚组的TC、LDL C水平均明显低于本组10 mg亚组（P<0.05）。治疗6个月后，两组及各亚组TG、TC、LDL C等血脂指标均较治疗前进一步明显下降（P<0.05），ALT也进一步明显升高（P<0.05），两组IMT较治疗前明显降低（P<0.05）；观察组及各亚组TG、TC、LDL C水平明显低于对照组及各相应亚组（P<0.05）；两组40 mg亚组的TG、TC、LDL C水平明显低于本组10 mg亚组（P<0.05），20 mg亚组的TC、LDL C水平明显低于本组10 mg亚组（P<0.05）。析因分析结果：增加阿托伐他汀剂量显著降低TG、TC、LDL C和升高ALT（P<0.05）。延长治疗时间显著降低TG、TC、LDL C、IMT和升高ALT（P<0.05）。用药种类和治疗时间对降低TC、LDL C有交互作用，阿托伐他汀剂量和治疗时间对降低TC、LDL C和升高ALT有交互作用（P<0.05）。结论：联用脂康颗粒提高了阿托伐他汀在动脉粥样硬化所致脑梗死二级预防中的效果。

英文摘要:

ABSTRACT Objective:To evaluate the effect of Zhikang granule combined with atorvastatin in secondary prevention of atherosclerosis induced cerebral infarction. Methods:180 patients were randomly divided into control group (n=90) and observation group (n=90). The control group was treated with atorvastatin, the observation group was treated with zhikang granule additionally. Each group was randomly divided into three subgroups, which was treated with atorvastatin of 10, 20 or 40mg, respectively. Both of two groups were given 6 months treatment. The level of triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT) and intimal medial thickness (IMT) was determined before treatment, 3 months and 6 months after treatment. The factorial designs were used to analyze the impacts of type of medications, atorvastatin doses and duration of treatment. Results:After treatment of 3 months, for both groups and each subgroups, the level of TG, TC and LDL C were dereased significantly than before(P<0.05). While the level of ALT was higher(P<0.05). The level of TG, TC and LDL C in observation group and all the subgroups were significantly lower than the control group and its subgroups(P<0.05). For both groups, in 40mg subgroup and 20 mg subgroup, the level of TC and LDL C decreased greatly when compared with those in 10mg subgroup (P<0.05). After treatment of 6 months, the level of TG, TC and LDL C in both groups were decreased greatly than before(P<0.05), while the level of ALT was higher further(P<0.05), the IMT of two groups were significantly lower than before(P<0.05). Compared to the control group and its subgroups, the level of TG, TC and LDL C in observation group were significantly lower(P<0.05). For both groups, the level of TG, TC and LDL C in 40mg subgroup, decreased greatly when compared with those in 10mg subgroup (P<0.05); the level of TC and LDL C in 20mg subgroup, decreased greatly when compared with those in 10mg subgroup (P<0.05). The factorial analysis results showed that there were significantly reduced TG, TC and LDL C, and elevated ALT when increased atorvastatin dose(P<0.05). There were significantly reduced TG, TC, LDL C and IMT, and elevated ALT when prolonged treatment time(P<0.05). There was interaction about reduced TC and LDL C between types of medication and duration of treatment, and about reduced TC and LDL C and elevated ALT between atorvastatin dose and duration of treatment(P<0.05). Conclusion:Zhikang granule combined use could elevate the effect of atorvastatin in the secondary prevention of atherosclerosis induced cerebral infarction.

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