阿托伐他汀治疗老年急性脑梗死患者临床疗效观察

Clinical study on atorvastatin in the treatment of acute cerebral infarction in the elderly

目的 探讨阿托伐他汀治疗老年人急性脑梗死的临床疗效. 方法 选取本科室2011年10月至2012年12月收治的急性脑梗死患者136例为研究对象,随机分为观察组和对照组.观察组68例,在常规治疗的基础上给予阿托伐他汀和阿司匹林治疗;对照组68例,在常规治疗的基础上给予阿司匹林治疗.观察两组患者临床疗效,以及临床指标改善情况. 结果 观察组痊愈率（42.7％比29.4％,x2=2.584,P=0.108）和总有效率（86.8％比79.4％,x2=1.821,P=0.177）均高于对照组,但差异无统计学意义.两组治疗后与治疗前比较,神经缺损评分和生活活动能力评分均有所改善,差异均有统计学意义[观察组：神经缺损评分（t=18.621,P＜0.001）,生活活动能力评分（t=10.544,P＜0.001）;对照组：神经缺损评分（t=15.026,P＜0.001）,生活活动能力评分（t=8.815,P＜0.001）];观察组与对照组神经缺损评分（t=1.179,P=0.120）和生活活动能力评分（t=0.321,P=0.374）比较,差异无统计学意义.治疗前观察组与对照组总胆固醇、三酰甘油、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇比较,差异均无统计学意义;治疗后两组总胆固醇（t=8.446,P＜0.001）、三酰甘油（t=4.145,P＜0.001）、低密度脂蛋白胆固醇（t=3.439,P=0.001）和高密度脂蛋白胆固醇（t=2.718,P=0.004）比较,差异均有统计学意义;治疗后观察组上述指标较治疗前改善均更为显著（P＜0.05）. 结论 阿托伐他汀联合阿司匹林治疗老年人急性脑梗死临床疗效好,可增强血脂相关指标的改善.

Objective To explore the clinical effect of atorvastatin on acute cerebral infarction treated with atorvastatin in the elderly.Methods 136 patients with acute cerebral infarction treated in our department from Oct.2011 to Nov.2012.And the patients were divided into observation group and control group.In observation group,68 cases were treated with conventional therapy plus Atorvastatin combined with aspirin.In control group,68 cases were treated with conventional therapy and aspirin.The clinical effect and safety were observed.Results In observation group versus control group,the cure rate （42.7% vs.29.4%,x2 =2.584,P =0.108） and total effective rate （86.8% vs.79.4%,x2 =1.821,P=0.177） showed no statistically significant differences.Posttreatment versus pre-treatment showed that neurological deficit score was improved both in observation group（t=18.621,P〈0.001） and in control group（t=15.026,P〈0.001） and activities of daily living improved both in observation group （t=10.544,P〈0.001）and in control group （t=8.815,P〈0.001）.The differences of in neurological deficit score （t=1.179,P=0.120） and activities of daily living （t =0.321,P =0.374） were not statistically significance between the two groups.Before treatment,there were no significant differences in total cholesterol （TC）,triglyceride （TG）,low density-lipoprotein-cholesterol （LDL-C） and high-density-lipoprotein-cholesterol （HDL-C）between the observation group and the control group.After treatment,the difference in improvement of TC （t=8.446,P〈0.001）,TG （t=4.145,P〈0.001）,LDL-C （t=3.439,P=0.001） and HDL-C（t=2.718,P=0.004） between observation group and control group were statistically significant.Conclusions Atorvastatin combined with aspirin as add-on therapy to conventional therapy plus aspirin has better efficacy in the treatment of acute cerebral infarction in the elderly,and improve the blood lipid related indicators and life activity.