阿托伐他汀钙强化序贯降脂治疗预防短暂性脑缺血发作复发的效果观察

Effect of atorvastatin calcium in intensive sequential lipid-lowering therapy for preventing the recurrence of transient ischemic attack

目的观察阿托伐他汀钙强化序贯降脂治疗预防短暂性脑缺血发作(TIA)复发的效果。方法将60例TIA患者随机分为治疗组和对照组,每组30例。所有患者均接受阿司匹林和氨氯地平的治疗,在此基础上,对照组加用阿托伐他汀钙10 mg/d治疗;治疗组进行阿托伐他汀钙40 mg/d强化降脂序贯治疗,出院后以阿托伐他汀钙20 mg/d继续降脂治疗。两组患者治疗前和治疗2周后进行血脂总胆固醇(CHOL)、低密度脂蛋白胆固醇(LDL-C)测定,随访半年观察TIA是否复发。结果两组的CHOL、LDL-C在治疗前差异无统计学意义(P>0.05);治疗后治疗组的CHOL、LDL-C与对照组比较,差异有统计学意义(P<0.01或0.05)。治疗组有2例复发,对照组有6例复发,并且有3例进展为脑梗死,两组复发率差异无统计学意义(P>0.05)。结论阿托伐他汀钙强序贯化降脂治疗能有效降低总胆固醇、低密度脂蛋白胆固醇,有利于预防TIA的复发。

Objective To observe the effect of atorvastatin calcium in intensive sequential lipid-lowering therapy for preventing the recurrence of transient ischemic attack （TIA）. Mothods 60 patients with TIA were randomly divided into Treatment Group and Control Group, 30 cases in each group. All the patients received the treatment with aspirin and amlodipine. On this basis, Control Group was further treated with 10 mg/d atorvastatin calcium while Treatment Group further received intensive sequential lipid-lowering therapy with 40 mg/d atorvastatin calcium, and continued to receive lipid- lowering therapy with 20 mg/d atorvastatin calcium after discharged. The total cholesterol （CHOL） and low density lipoprotein cholesterol （LDL-C） were detected before treatment and 2 weeks after treatment respectively. All patients were followed up for six months to observe whether there was recurrence ofTIA. Rosults There was no difference in LDL-C and CHOL between the two groups before treatment （P〉0.05）; After treatment, there was statistical difference in LDL-C and CHOL between Treatment Group and Control Group （P〈0.01 or 0.05）. There were 2 cases of recurrence in Treatment Group while there were 6 cases in Control Group, of which 3 cases progressed to cerebral infarction, and there was no statistical difference in the recurrence rate between the two groups （P〉0.05）. Conclusion Atorvastatin calcium for intensive sequential lipid-lowering therapy can significantly reduce the total cholesterol and low density lipoprotein cholesterol levels, and helps to prevent the recurrence of TIA.