阿托伐他汀治疗急性缺血性脑卒中的量效关系探讨

Study on dose-effect relationship in atorvastatin therapy for acute ischemic stroke

目的探讨不同剂量阿托伐他汀治疗急性缺血性脑卒中的临床疗效。方法将125例急性缺血性脑卒中患者随机分为3组,阿托伐他汀剂量为A组10 mg/d,B组20 mg/d,C组不加用任何调脂药物。比较治疗前后3组患者血脂、炎性因子和纤维蛋白原(FIB)水平,以及神经功能缺损情况和日常生活能力的变化。结果 B组TC、TG、LDL-C下降幅度显著大于A组(P<0.05);A、B组炎性因子水平下降幅度及ADL及NIHSS评分改善幅均显著大于C组(P<0.01),且B组炎性因子和FIB水平下降幅度显著大于A组(P<0.05)。结论与10 mg/d的剂量相比,20 mg/d的阿托伐他汀治疗急性缺血性脑卒中患者,可更为有效地降脂、抗炎,从而稳定动脉粥样硬化斑块,恢复神经系统损伤,提高生活质量,且安全性较好。

Objective To investigate the clinical effect of different doses of atorvastatin in the treatment of acute ischemic stroke. Methods One hundred and twenty-five cases of acute ischemic stroke were divided into three groups randomly. Group A received atorvastatin 10 mg/d, group B received atorvastatin 20 mg/d, and group C did not receive any lipid-lowering drugs. The blood levels of lipids, inflammatory cytokines, and fibrinogen （ FIB）, neurological impairment status, and viability before and after treatment were e- valuated among the three groups. Results The decreases in levels of total cholesterol, triglyceride, and low-density lipoprotein choles- terol in group B were significantly higher than those in group A （ P 〈 0.05 ）. The decreases in levels of inflammatory cytokines and in- creases in scores of Activities of Daily Living and National Institute of Health Stroke Scale in groups A and B were significantly higher than those in group C （P 〈0.01 ）. The decreases in levels of inflammatory cytokines and FIB in group B were significantly higher than those in group A （P 〈 0. 05）. Conclusions For patients with acute ischemic stroke, atorvastatin 20 mg/d, compared with atorvastatin 10 mg/d, can lower lipid levels and reduce inflammation more effectively, so as to stabilize atherosclerotic plaques, restore the nervous system function, and improve the quality of life with higher safety.