大剂量瑞舒伐他汀治疗老年急性脑梗死患者的疗效

Curative effects of high-dose rosuvastatin in elderly patients with acute cerebral infarction

目的 观察使用大剂量瑞舒伐他汀治疗老年急性脑梗死(acute cerebral infarction, ACI)患者的临床疗效,并探讨其对颈动脉粥样硬化(atherosclerosis, AS)斑块、脂代谢及外周血补体C3、C4水平的影响。方法 将94例首发ACI患者随机均分为对照组(n=47)和观察组(n=47)。对照组予以小剂量(10 mg·d^(-1))瑞舒伐他汀治疗,观察组予以大剂量(20 mg·d^(-1))瑞舒伐他汀治疗,2组均治疗12周。分别于治疗前和治疗12周后采用美国国立卫生院脑卒中量表(National Institutes of Health Stroke Scale, NIHSS)评分评价神经功能,测量总胆固醇(total cholesterol, TC)、三酰甘油(triglyceride, TG)、低密度脂蛋白(low-density lipoprotein cholesterol, LDL-C)和高密度脂蛋白(high-density lipoprotein cholesterol, HDL-C),测定外周血补体C3、C4水平以及颈动脉内中膜厚度(intima-media thickness, IMT)、斑块厚度,比较治疗疗效。结果 治疗12周后,观察组的血脂指标(TC、TG和LDL-C)、NIHSS评分、补体C3、C4水平以及IMT值和斑块厚度均明显低于对照组(P<0.05);观察组有效率(91.49%)明显高于对照组(74.47%),P<0.05。结论 大剂量瑞舒伐他汀能更有效地降低ACI患者血脂、补体水平,稳定AS斑块,改善神经功能缺损。

Objective To observe the clinical curative effect of high-dose rosuvastatin in elderly patients with acute cerebral infarction(ACI), and explore its influences on atherosclerosis(AS) plaques, lipid metabolism and peripheral blood complements C3 and C4. Methods A total of 94 patients with first-episode ACI were randomly divided into control group(47 cases) and observation group(47 cases). The control group were treated with low-dose(10 mg·d-1) rosuvastatin, while the observation group were treated with high-dose(20 mg·d-1) rosuvastatin. All were treated for 12 weeks. Before and after 12 weeks of treatment, the nerve function was evaluated by National Institutesof Health Stroke Scale(NIHSS).The levels of plasma total cholesterol(TC), triglyceride(TG), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C) and peripheral blood complements(C3, C4), carotid intima-media thickness(IMT) and plaque thickness were detected. And the curative effect between the 2 groups was compared.Results After 12 weeks of treatment, the blood lipid indexes(TC, TG, LDL-C), NIHSS score, complements(C3, C4), IMT and plaque thickness in observation group were significantly lower than those in control group(P<0.05), and the response rate was significantly higher than that in control group(91.49% vs. 74.47%)(P<0.05).Conclusion High-dose rosuvastatin can more effectively reduce the levels of blood lipid and complements in ACI patients, stabilize AS plaques and improve neurological deficits.