阿托伐他汀对急性脑梗死患者超敏C反应蛋白及颈动脉内膜中层厚度的影响

Effect of Atorvastatin on High Sensitivity C - reactive Protein and Carotid Artery Intima - media Thickness in Patients with Acute Cerebral Infarction

目的观察阿托伐他汀对急性脑梗死患者超敏C反应蛋白(hs-CRP)及颈动脉内膜中层厚度(IMT)的影响。方法将入选的82例急性脑梗死患者随机分为治疗组42例和对照组40例,对照组用常规治疗方法,不服用他汀类药物。治疗组在对照组常规治疗的基础上加阿托伐他汀钙20 mg/次,每晚用餐时口服。两组均连续治疗12个月。观察两组治疗前后的疗效、血清hs-CRP水平及颈动脉IMT的变化情况。结果用药12个月后,治疗组基本痊愈29例,显著进步10例,进步3例;对照组基本痊愈20例,显著进步11例,进步3例,无变化4例,恶化1例,死亡1例,两组疗效间差异有统计学意义(u=-2.089,P<0.05)。治疗组血清hs-CRP水平、IMT比治疗前及对照组均显著降低(t值分别为6.4361、5.6901和5.1182、2.6749,P均<0.05)。阿托伐他汀的不良反应轻微。结论阿托伐他汀能有效降低hs-CRP水平,减轻血管炎性反应,减少颈动脉内膜中层厚度,稳定和减轻颈动脉粥样硬化斑块,疗效显著,安全性好。

Objective To observe the effect of atorvastatinonhigh sensitivity C-reactive protein andcarotidartery intima-media thickness in patients with acute cerebral infarction.Methods 82 patients with acute cerebral infarction patients were divided into treatment group（42 patients） and control group（40 patients）.The control group received routine treatment,without taking statins,and the treatment group were added oral atorvastatin calcium（20 mg/time,once a day） on the basis of conventional treatment in the control group.Both groups were treated continuously for 12 months.Efficacy,high sensitivity creactive protein（hs-CRP） concentration and carotid artery intima-media thickness（IMT） were observed in 2 groups before and after treatment.Results After 12 months treatment,the treatment group： basic recovery 29 cases,Significant progress 10 cases,progress 3 cases;the control group： basic recovery 20 cases,Significant progress 11 cases,progress 3 cases,no change 4 cases,deterioration 1 case,death 1 case.Difference of treatment effect between two groups was statistically significant（u =-2.089,P 0.05）.The serum hs-CRP levels and IMT of the treatment group were significantly lower than that before treat-ment and the control groups（t = 6.4361,5.6901,5.1182,2.6749,P all 0.05）,and the adverse reactions of atorvastatin were mild.Conclusion Atorvastatin can reduce hs-CRP levels,alleviate blood vessel inflammation,reduce carotid intima-media thickness,stabilize and reduce carotid atherosclerotic plaques with obvious effect and good security.