瑞舒伐他汀与阿托伐他汀对急性脑梗死患者血脂、血清超敏C反应蛋白及颈动脉粥样硬化斑块作用的比较

Comparison of effects of Rosuvastatin and Atorvastatin on blood lipid,serum high-sensitivity C reactive protein and carotid atherosclerotic plaques in patients with acute cerebral infarction

目的比较瑞舒伐他汀与阿托伐他汀对急性脑梗死患者血脂、超敏C反应蛋白(hs-CRP)及颈动脉粥样硬化斑块的影响。方法在标准缺血性脑卒中治疗的基础上,瑞舒伐他汀组加用瑞舒伐他汀10mg/d,阿托伐他汀组加用阿托伐他汀片20 mg/d,治疗6个月。于治疗前及治疗后6个月,检测患者血脂、hsCRP水平,颈动脉超声检查颈动脉粥样硬化斑块情况。结果与治疗前比较,瑞舒伐他汀组与阿托伐他汀组6个月时总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和hs-CRP水平均显著降低(均P<0.05)。6个月时,瑞舒伐他汀组TC、TG、LDL-C及hs-CRP水平显著低于阿托伐他汀组及对照组(均P<0.05)。3组间治疗前内-中膜厚度(IMT)差异无统计学意义;与治疗前及对照组比较,瑞舒伐他汀组与阿托伐他汀组6个月时IMT及低回声斑块比率显著降低,高回声斑块率显著增高(均P<0.05)。瑞舒伐他汀组、阿托伐他汀组及对照组患者第6个月的NIHSS评分及mRS评分均显著低于治疗前(均P<0.05)。治疗前及治疗后6个月时,3组间NIHSS评分及mRS评分差异无统计学意义。结论瑞舒伐他汀与阿托伐他汀能显著降低急性脑梗死患者血脂及血清hs-CRP水平,抑制动脉粥样硬化斑块的形成。瑞舒伐他汀的降脂及抗炎作用比阿托伐他汀更强。

Objective To Compared the effect of Rosuvastatin and Atorvastatin on blood lipid,serum highsensitivity C reactive protein（ hs-CRP） and carotid atherosclerotic plaques in patients with acute cerebral infarction（ ACI）. Methods Based on the standard therapy of cerebral ischemic stroke,Rosuvastatin group was treated with Rosuvastatin tablets 10 mg / d,Atorvastatin group was treated with Atorvastatin tablets 20 mg / d,lasting for 6 months.The levels of blood lipid and hs-CRP were detected,and atherosclerotic plaque were observed by carotid ultrasound before treatment and 6 month after treatment. Results Compared with pretreatment,the levels of total cholesterol（ TC）,triglycerides（ TG）,low density lipoprotein cholesterol（ LDL-C）,hs-CRP in Rosuvastatin group and Atorvastatin group were significantly decreased（ all P〈0. 05）. At 6th month after treatment,the levels of TC,TG and LDL-C and hs-CRP in Rosuvastatin group were significantly decreased than those in Atorvastatin group and control group（ all P〈0. 05）. There was no statistical significance of intima-media thickness（ IMT） in the 3 groups before treatment. Compared with pretreatment and control group, IMT and the rate of hypoechoic plaque in Rosuvastatin group and Atorvastatin group at 6th month after treatment were significantly decreased,and the rate of hyperechoic plaque were significantly increased（ all P〈0. 05）. At 6th month after treatment,the NIHSS and mRS scores in Rosuvastatin group, Atorvastatin group and control group were significantly decreased than that in pretreatment（ all P〈0. 05）. There was no statistical significance of NIHSS and mRS scores in the 3 groups before treatment and 6 month after treatment. Conclusions Rosuvastatin and Atorvastatin can reduce the levels of blood lipid and hs-CRP in ACI patients,and inhibiting the atheromatous plaque formation. Rosuvastatin has stronger effect than Atorvastatin.