A Study Of Probucol Combined With Atorvastatin On The Prognosis Of Patients With Acute Cerebral Infarction

Objective and background:Atherosclerosis(AS) is the main pathological basis of the most of the occurrence of ischemic stroke.It is mainly formed by the interaction of lipid deposition and oxidative stress. A large number of lipid deposition in macrophages may promote plaque formation,accelerate the progression and rupture of plaque,resulting in severe stroke and other cardiovascular events.In recent years, it is found and confirmed that oxidative stress played an important role in the occurrence, development and rupture process of atherosclerosis, the oxidative modification of LDL-C is the key step of AS,and oxidized low density lipoprotein(ox-LDL) has piayed a stronger role in induced atherosclerosis than LDL-C in the domestic and foreign research.So antioxidant stress therapy has become a clear and key target in treating the atherosclerotic disease.Using the method of prospective study,it leads to observe study the effect of probucol combined with atorvastatin on the prognosis of patients with acute cerebral infarction and further investigate the important of the anti oxidative stress treatment of atherosclerosis in patients with acute ischemic stroke.Subjects:Patiens group:This study selected 84 patients with acute ischemic stroke from June2012 to July 2014,including 44 males and 40 females, mean age(68.74 ± 9.05)years old.The control group: 40 persons with no stroke,including 21 males and females,mean age(69.12± 8.71)years old.Methods:Age,sex, obesity, smoking, drinking, past medical history, biochemical indexes and nerve function defect score were recorded.All data were analyzed with SPSS 19 statistical software. Measurement data are expressed by using mean and standard deviation, and were compared by t-test.The chi-square test is used in qualitative data. P < 0.05, the difference is statistically significant.Results:This study selected 84 patients with acute ischemic stroke,and 40 persons with no stroke as the control group. TC,TG,HDL-C,LDL-C,ox-LDL and hs-CRP compared as the lipid risk factors between the two groups,respectively,P<0.001,P<0.001,P=0.03<0.05,P<0.001,P<0.001,P<0.001。In patients with acute cerebral infarction were divided into the routine treatment group and the combined treatment group.The results showed that: after 4 months treatment, the level of TC, TG, LDL-C, HDL-C respectively were(4.55 ± 1.18)mmol/L,(1.97 ± 0.72)mmol/L,(2.74 ± 0.69)mmol/L and(1.22±0.30)mmol/L in the routine treatment group, similarly they respectively were(4.01 ± 1.07)mmol/L,(1.63 ± 0.81)mmol/L,(2.47 ± 0.51)mmol/L and(1.24±0.25)mmol/L in the combined treatment group.After treatment the level of TC, TG, and LDL-C were significantly decreased and the level of HDL-C increased(P < 0.05) in the two groups, and serum TC, TG, LDL-C in the combined treatment group were significantly lower than those in the routinel treatment group(P > 0.05); Comparison of HDL-C levels in the two groups, the difference was not statistically significant(P > 0.05).After treatment, the levels of ox-LDL in the two groups were(33.25±13.19)μmol/L and(25.47±12.83)μmol/L.After the treatment,the levels of ox-LDL in combined treatment group decreased significantly(P < 0.01);in the routine treatment group was decreased, but the difference was not statistically significant(P > 0.05).The difference between the two group had significant meaning after treatment( P=0.008<0.01).After 4 months treatment,the levels of hs-CRP in the two groups were(9.24 ± 3.96)mg/L and(6.83 ± 3.32)mg/L.Compared with before treatment,hs-CRP were significantly lower in the two groups(P < 0.01).The difference between the two group had significant meaning after 4 months treatment( P=0.003<0.01).After treatment, 25(62.5%) cases were effective in the routine treatment group,and in the combined treatment group 36(81.8%) cases were effective.The difference between the two group had significant meaning after 4 months treatment(P =0.047< 0.05).The neural function defect scores in the two groups were 14.7±6.3 and11.2±5.6 after the treatment.Compared with before treatment,The neural function defect scores were significantly decreased in the two groups(P < 0.01).The difference between the two group had significant meaning after 4 months treatment(P=0.009<0.01).Conclusions:1.It can be learned that cholesterol is an important controllable risk factor for ischemic stroke patients in our country in this research, Statins can not only control blood lipid, but alsocould inhibit inflammation and improve the defect of nerve function in order to play a role in neural protection.2.Antioxidants can effectively reduce the levels of serum ox-LDL in patients with ischemic stroke, and can improve the clinical outcome of patients with stroke via antioxidant effects, suggesting that ox-LDL may become a key to cause ischemic stroke by some mechanism.3.Antioxidants associated with statin therapy can significantly reduce the level of serum lipids and hs-CRP in patients with acute ischemic stroke, thus synergistically play a lipid-lowering, antioxidant and anti-inflammatory effects, and significantly improve the clinical efficacy in patients with acute cerebral infarction.