| Background and objective As a gusty,transient and reversible nerve dysfunction,transient cerebral ischemia attack(TIA)results from focal cerebral ischemia since insufficient blood supply happens in carotid artery or vertebro-basilar system.It is a dangerous inducing factor of cerebral infarction.Once progressed to cerebral infarction,different levels of disability and sensation disturbance would be left over.In consequence,treating TIA and preventing it developing to cerebral infarction has become one of the important tasks for Neurology.This study aims to investigate the clinical effects of atorvastatin calcium and clopidogrel in treating TIA and preventing cerebral infarction as well as its impacts on blood fat,arteriosclerosis plaque of carotid artery,coagulation indicators and blood platelets.Methods 76 patients between 55 and 75 years old who came to our hospital in February 2013 to February 2015 for treating TIA(low-risk population with ABCD2 score<3 who were not hospitalized but treated and followed up by the Outpatient Department of Neurology)were chosen as our objects.They were randomly divided into the observation and control group with each group of 38 cases.For patients in the observation group,20 mg of atorvastatin calcium in combination with 75 mg of clopidogrel were taken while only 75 mg of clopidogrel was taken by patients in the control group.For all the patients in both groups,they were followed up after one-year treatment and compared their blood fat,carotid plaque,coagulation indicators(PT,APTT),blood platelet(PLT),the morbidity of infarction,the effects on treating TIA and preventing cerebral infarction as well as occurrence rates of adverse events after taking medicine.Results Before treatment,patients in both groups have no statistical difference in age,gender and underlying diseases.The comparison of both groups in TC,TG and LDL-C have no statistic difference(P>0.05).While after treatment,levels of TC,TG and LDL-C of the observation group are significantly lower than that of this group before treatment(P<0.05)and that of the control group after treatment(P<0.05).For the control group,blood fat indicators before treating and after treating have no significant difference(P>0.05).Before treating,patch numbers of high-level echo and hypoecho of carotid artery have no statistical difference(P>0.05).After treating,carotid artery hypoecho patch numbers for observation group patients were significantly lower than that of this group before treatment(P<0.05)and that of the control group after treating(P<0.05).For the control group,carotid artery hypoecho patch numbers both before and after treatment have no statistical difference(P>0.05).For both groups,carotid artery high-level echo patch numbers,PT,APTT and PLT indicators have no significant difference(P>0.05)no matter whether they were treated.After one year of treatment,2 of 38 in the observation group were found to be with cerebral infarction with the morbidity of 5.26%(2/38)while 8 of 38 in the control group had cerebral infarction with morbidity of 21.05%(8/38).It is statistically different(?2=4.145,P=0.042<0.05).For both groups,no patients was found to have intracranial hemorrhage or alimentary tract hemorrhage after one year.3 patients in the observation group had poor appetite,nausea and vomiting and transaminase elevation with the occurrence rate of 7.89%.For control group,there were 2 patients who had skin rash and diarrhea with the occurrence rate of 5.26%.Though patients with untoward effects in the observation group were more than that in the control group,there was no significantly difference(?2=0.214,P=0.644>0.05)yet.Conclusions Firstly,the combination of atorvastatin calcium with clopidogrel is more effective in reducing levels of TC,TG and LDL-C than single use of clopidogrel.Besides,the combination can significantly reduce numbers of unstable carotid plaques of carotid artery hypoecho so that patches can be stabilized and reduced.However,it has little effect on stable patches of high-level echo patches.Secondly,the combination of atorvastatin calcium with clopidogrel can be more effectively in decreasing the occurrence rates of cerebral infarction of TIA patients than single use of clopidogrel,which on some extent can prevent cerebral infarction.Thirdly,the combination of atorvastatin calcium with clopidogrel has less untoward effects and higher safety.Both combination and single dose of medicine have no significant influence on patients' coagulation function(PT,APTT)and platelet counts. |
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