脑梗死急性期他汀用药剂量与康复预后相关性的回顾研究

The retrospective research of the rehabilitative effect of atorvastatin with different dosage used in the acute stage on patients with cerebral infarction

目的探讨脑梗死急性期口服不同剂量阿托伐他汀对患者临床康复预后的影响。方法回顾性分析356例脑梗死患者的临床资料,根据患者住院期间口服阿托伐他汀剂量进行分组,20 mg组153例,40 mg组137例,60 mg组19例,80 mg组47例,比较分析各组患者的人口学资料、脑血管病危险因素分布及主要危险因素控制用药种类分布和NIHSS评分。结果各组患者人口学资料、脑血管病危险因素分布和主要危险因素控制用药种类分布差异无统计学意义。组间NIHSS评分有效率差异有统计学意义（χ~2=8.041,P=0.045）,应用卡方分割法进一步检验,显示20~40 mg组与60~80 mg组NIHSS评分有效率差异具有显著性（有效率分别为32.76%、50.00%,χ~2=6.941,P=0.008）。Logistic回归分析显示阿托伐他汀剂量为急性脑梗死临床康复预后的独立影响因素,OR值为1.382,95%可信区间1.111~1.719,P=0.004。结论脑梗死急性期应用高剂量阿托伐他汀对于改善患者康复预后具有更好的促进作用。

Objective To investigate the rehabilitative effect of atorvastatin with different dosage used in the acute stage on patients with cerebral infarction. Methods A total of 356 patients with cerebral infarction was retrospectively analyzed. The patients were divided into 20 mg group, 40 mg group, 60 mg group and 80 mg group according to the dosage of atorvastatin used in the acute stage of the diseases, then the demographic data, risk factors of cerebral vascular disease,drug types relative to the main risk factors and the change of NIHSS of every group were comparatively analyzed. Results The differences of the demographic data, risk factors of cerebral vascular disease and the drug types relative to hypertension and diabetes mellitus among the four groups were not statistically significant. But there was statistically significant difference in the effective percentage according to change of NIHSS. The effective percentage of 20 mg and 40 mg group was significantly lower than that of 60 mg and 80 mg group（χ~2=6.941,P = 0.008）. Logistic analysis showed that the dosage of atorvastatin was a factor that had independent effect on rehabilitative prognosis in patients with acute cerebral infarction（OR=1.382, P = 0.004）. Conclusion In acute stage of cerebral infarction, using atorvastatin with high dosage can improve the rehabilitation more effectively than that of low dosage.