不同剂量阿托伐他汀在急性缺血性卒中患者中的应用比较

The clinical efficacy of atorvastatin on patients with acute ischemic stroke

目的探讨不同剂量阿托伐他汀治疗急性缺血性卒中的临床疗效。方法将广州市红十字会医院在2010年1月至2012年7月收治的168例急性缺血性卒中患者分为3组:每组各56例;Ⅰ组患者给予阿托伐他汀20 mg/d,Ⅱ组患者给予阿托伐他汀10 mg/d,Ⅲ组患者为空白对照组,持续治疗并随诊9个月。比较治疗前后3组患者的低密度脂蛋白胆固醇(LDL-C)、踝臂指数(ABI)、颈动脉内中膜厚度(CIMT)水平及不良反应的发生率情况。结果Ⅰ、Ⅱ组患者治疗后的LDL-C水平均显著低于治疗前(P均<0.05),同时Ⅰ、Ⅱ组患者的LDL-C水平均显著低于Ⅲ组患者(P均<0.05),且Ⅰ组患者LDL-C水平比Ⅱ组下降更明显(P<0.05)。治疗9个月后,Ⅰ组患者ABI及CIMT与治疗前比较差异均有统计学意义(P均<0.05)。治疗后Ⅰ组患者的不良事件发生率均显著低于Ⅱ、Ⅲ组(P均<0.05)。3组患者均没有发生严重的不良反应。结论20 mg/d剂量的阿托伐他汀可以有效降低LDL-C水平,显著提高ABI水平及降低颈动脉内中膜厚度,还可显著降低脑血管不良事件的发生率。

Objective To explore the clinical efficacy of atorvastatin on patients with acute isehemic stroke. Methods A total of 168 patients with acute ischemic stroke who admitted into Guangzhou Redcross Hospital from January 2010 to July 2012 were randomly divided into three groups, 56 cases for each group. Patients in groups I and Ⅱ were orally given atorvastatin 20 mg/d and 10 mg/ d for 9 months, respectively, and patients in group Ⅲ served as control. The low-density lipoprotein cholesterol （LDL-C）, ankle braehial index （ABI）, carotid intima-media thickness （CIMT） and the incidence of adverse reactions of the three groups before and after treatment were examined and compared. Results The LDL-C levels in groups I and Ⅱ decreased after treatment （all P〈 0.05）. The LDL-C levels in groups I and Ⅱ were significantly lower than those in group m （all P 〈 0.05）, and were much lower in group I （P 〈 0.05）. In group I , the ABI levels were lower and the CIMT levels were higher after the treatment （all P〈 0.05）, and the incidence of adverse events were significantly lower than those in groups Ⅱ and Ⅲ after the treatment （all P 〈 0.05）. However, there were no serious adverse reactions among the three groups. Conclusion Atorvastatin in 20 mg/d can effectively decrease LDL-C levels, improve the ABI level, reduce the CIMT level and decrease down the incidence of adverse events.