小剂量瑞舒伐他汀钙对老年短暂性脑缺血发作患者二级预防的疗效

Curative effect of secondary prevention of small dose Rosuvastation Calcium in elderly patients with transient ischemic attack

目的探讨小剂量瑞舒伐他汀钙对老年短暂性脑缺血发作（TIA）患者二级预防的疗效。方法检测103例老年TIA患者的血脂、血浆高敏C反应蛋白（hs—CRP）及同型半胱氨酸（Hcy）水平及颈动脉粥样硬化斑块状况。给予5mg／d的瑞舒伐他汀钙进行治疗，于治疗后30d及180d进行复查，并随访6个月。结果与治疗前比较，治疗后30d及180d时患者总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL—C）、载脂蛋白A（ApoA）、载脂蛋白B（ApoB）、hs—CRP、Hcy均显著下降，高密度脂蛋白胆固醇（HDL—C）升高（P〈0．05～0．01）。治疗第30d时LDL—C〈2．07mmol／L的达标率为23．4％，180d时为40．2％；治疗30d时LDL—C下降幅度〉40％的达标率为30．8％，180d时为64．2％。与治疗前比较，治疗后30d时颈动脉内-中膜厚度（IMT）明显减少（P〈0．05）；治疗后180d时IMT、低密度及混合密度斑块面积均明显减少（均P〈0．01）。随访6个月内，TIA再发作11例（10．7％）；出现丙氨酸转氨酶（ALT）〉1倍正常上限的患者9例（8．7％），ALT〉3倍正常上限1例（1．0％），天冬氨酸转氨酶（AST）〉1倍正常上限8例（7．8％），AST〉3倍正常上限2例（1．9％）。结论小剂量瑞舒伐他汀钙对老年TIA患者是安全有效的，适合脑卒中二级预防的长期使用。

Objective To investigate the effect of secondary prevention of small dose Rosuvastation Calcium in elderly patients with transient ischemic attack （TIA）. Methods The level of blood lipid, high-sensitivity C-reactive protein （hs-CRP） and homocysteine （Hey） and carotid artery plaque were detected in 103 elderly patients with TIA. Patients treated with Rosuvastatin calcium dose of 5 rag/d, and reexamined 30 d and 180 d after treatment. Patients were followed up for 6 months. Results Compared with pre-treatment, the level of total cholesterol （ TC）, trigalloyl glycerol （TG） , low density lipoprotein cholesterol （LDL-C） , apoprotein A （ Apo A） , apoprotein B （ Apo B） , hs- CRP, Hcy in 30 d and 180 d after treatment were significantly decreased, and high density lipoprotein cholesterol （HDL-C） was increased （ P 〈 0. 05 - 0. 01 ）. The rate of reaching standard of LDL-C 〈 2.07 mmol/L was 23.4% in 30 d after treatment, and there was 40. 2% in 180 d after treatment. The rate of reaching standard of LDL-C 〉40% was 30. 8% in 30 d after treatment, and there was 64.2% in 180 d after treatment. Compared with pre-treatment, the intima-media thickness （IMT） in 30 d after treatment were significantly decreased （P 〈 0.05 ）, and the IMT, low-density and mixed-density plaque area were significantly reduced in 180 d after treatment （all P 〈 0.01 ）. Follow-up 6 months, the TIA recurrence rate was in 11 cases （10. 7% ）, alanine transaminase （ALT） 〉 1ULN was in 9 cases （ 8.7% ）, ALT 〉 3 upper limit of normal （ULN） in 1 case （ 1.0% ） , aspartate transaminase （AST） 〉 1ULN in 3 cases （7.8%） , ALT 〉 3ULN in 2 cases （ 1.9% ）. Conclusion Small dose Rosuvastation Calcium for the elderly TIA patient is safe and effective, and suitable for long-term adherence to evidence-based secondary prevention therapies in cerebral stroke.