大剂量辛伐他汀强化治疗对缺血性脑血管病患者血脂水平及脑血管储备能力的临床价值

Clinical value of effect of high dose simvastatin in intensive treatment of patients with ischemic cerebrovascular disease on blood lipid levels and cerebral vascular reactivity

目的探讨大剂量辛伐他汀强化治疗对缺血性脑血管病患者血脂水平及脑血管储备能力的影响。方法缺血性脑血管病患者108例,采用随机数字表法分为两组,54例患者采用常规剂量辛伐他汀治疗为对照组,54例患者采用大剂量辛伐他汀强化治疗为观察组。结果两组治疗后总胆固醇、甘油三酯、低密度脂蛋白胆固醇较治疗前显著降低,高密度脂蛋白胆固醇、脑血管储备能力、屏气指数较治疗前显著增加。观察组患者总胆固醇(3.8±0.6)mmol/L、甘油三酯(1.9±0.2)mmol/L、低密度脂蛋白胆固醇(2.8±0.6)mmol/L均明显低于对照组(4.3±0.5)mmol/L、(2.2±0.3)mmol/L、(3.2±0.4)mmol/L,高密度脂蛋白胆固醇(1.4±0.3)mmol/L、脑血管储备能力(34.2±2.7)分、屏气指数(1.3±0.3)、治疗总有效率98.1%均明显高于对照组(1.2±0.2)mmol/L、(25.0±3.1)分、(1.0±0.2)、85.2%,差异有统计学意义(P<0.05)。结论大剂量辛伐他汀强化治疗缺血性脑血管病的效果显著,可明显改善患者的血脂水平及脑血管储备能力。

Objective To explore effect of high dose simvastatin in intensive treatment of patients with ischemic cerebrovascular disease on blood lipid levels and cerebral vascular reactivity. Methods 108 patients with ischemic cerebrovascular disease were randomly allocated to the control group and the observation group according to random number table, with 54 in each. The control group was treated with routine dose simvastatin while the observation group was intensively treated with high dose simvastatin. Results After treatment, total cholesterol, triglyceride and low density lipoprotein cholesterol of two groups were significantly decreased while high density lipoprotein cholesterol, cerebral vascular reactivity and breath-holding index were significantly increased compared with those before treatment. Total cholesterol, triglyceride and low density lipoprotein cholesterol of the observation group were（3.8±0.6） mmol/L,（1.9±0.2） mmol/L and（2.8±0.6） mmol/L respectively, all significantly lower than those of the control group（4.3±0.5） mmol/L,（2.2±0.3） mmol/L and（3.2±0.4） mmol/L. High density lipoprotein cholesterol, cerebral vascular reactivity, breath-holding index and total effective rate of the observation group were（1.4±0.3） mmol/L,（34.2±2.7） points,（1.3±0.3） and 98.1% respectively, all significantly higher than those of the control group（1.2±0.2） mmol/L,（25.0±3.1） points,（1.0±0.2） and 85.2%（P〈0.05）. Conclusion High dose simvastatin in intensive treatment of patients with ischemic cerebrovascular disease has significant effect and it can significantly improve blood lipid levels and cerebral vascular reactivity of patients.