瑞舒伐他汀改善动脉硬化性脑梗死患者血脂与神经功能的临床研究

Efficacy of rosuvastatin on neurofunctional and blood lipid in patients with arteriosclerotic cerebral infarction

目的:探讨瑞舒伐他汀对动脉硬化性脑梗死患者血脂与神经功能的影响及其临床意义。方法:将62例动脉硬化性脑梗死患者,按前瞻随机开放法分为观察组与对照组,各31例。根据不同病情,合理给予抗血小板聚集药物、清除氧自由基药物及活血化瘀药物;观察组在上述基础上加用瑞舒伐他钙汀片,比较2组治疗前及治疗后3、6、12个月血脂、神经功能、颈动脉内膜-中层厚度(IMT)及梗死灶面积。结果:与对照组比较,观察组患者治疗12个月后,胆固醇、三酰甘油、低密度脂蛋白均明显降低(P<0.01),高密度脂蛋白明显升高(P<0.01),IMT明显减小(P<0.01),神经功能得到明显改善(P<0.01);治疗前2组梗死灶面积比较差异无统计学意义(P>0.05);经治疗后,2组梗死灶面积均有所改善,其中观察组治疗12个月后大面积、小面积梗死灶分别减少3例和7例(改善率41.2%);对照组治疗12个月后大面积、小面积梗死灶分别减少1例和4例(改善率22.2%),但2组治疗后3、6、12个月脑梗死面积改善情况差异均无统计学意义(P>0.05)。结论:瑞舒伐他汀能明显改善脑梗死患者的血脂及神经功能,不良反应少,对改善脑梗死临床预后具有重要意义。

Objective： To explore the effect of rosuvastatin on the blood lipid and neurofunctional of patients with arteriosclerotic cerebral infarction. Methods： Sixty-two patients with cerebral infarction were divided into observation group and control group by a prospective randomized open method. Conventional therapy such as anticoagulants,dehydrating agent and drugs to improve the microcirculation was applied to all the patients; and the patients in the observation group were administered statin rosuvastatin calcium tablets in addition to the routine therapy. The blood lipid,nerve function,carotid intima- media thickness（ IMT） and the infarct size were compared between the two groups before treatment,3,6 and 12 months after treatment. Results： Compared with the control group,the TC,TG and LDL of the observation group decreased（ P〈0. 01）,the HDL increased（ P〈0. 01）,the IMT diminished（ P〈0. 01）and the nerve function improved significantly after 12 months of treatment（ P〈0. 01）. Before treatment,the infarct area had no significant difference between the two groups（ P〉0. 05）; after treatment,the infarct area in the two groups diminished significantly.After 12 months of therapy,3 cases of large area of infarct and 7 cases of small area of infarct in the observation group improved（ 41. 2%）,and 1 case of large area of infarct and 4 cases of mall area of infarct in the control group improved（ 22. 2%）. The difference in the infarct area was not statistically significant after treatment for 3 months,6 months or 12 months（ P〉0. 05）. Conclusions：Rosuvastatin can significantly improve the cerebral blood lipid and nerve function,decrease the adverse reactions and improve the clinical outcome of patients with cerebral infarction.