不同剂量瑞舒伐他汀治疗急性脑梗死的临床观察

Clinical Observation of Different Doses of Rosuvastatin in the Treatment of Acute Cerebral Infarction

目的:观察不同剂量瑞舒伐他汀在急性脑梗死患者治疗中的有效性及安全性。方法:选取2014年1月-2015年12月潍坊市益都中心医院收治的急性脑梗死患者120例,按照入院先后顺序分为观察组和对照组,各60例。两组患者均给予舒血宁注射液10 m L,iv,每日1~2次(或者20 m L加至5%葡萄糖注射液250~500 m L中,ivgtt,qd)+阿司匹林肠溶片0.1 g,po,qd等基础治疗;对照组和观察组在基础治疗方案上分别给予瑞舒伐他汀钙片10 mg和20 mg,po,qd(晚餐后)。两组患者均治疗30 d。观察两组患者治疗前后血清炎症因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6]和血脂指标[总胆固醇(TC)、三酰甘油(TG)和低密度脂蛋白胆固醇(LDL-C)]水平、神经功能和日常生活能力评分,以及临床疗效和不良反应发生情况。结果:治疗前,两组患者hs-CRP、TNF-α、IL-6、TC、TG、LDL-C水平以及美国国立卫生院脑卒中量表(NIHSS)评分和日常生活活动能力量表(BI)评分等比较,差异均无统计学意义(P>0.05)。治疗后,两组患者hs-CRP、TNF-α、IL-6、TC、TG、LDL-C水平和NIHSS评分均显著降低,BI评分显著升高,且观察组显著优于对照组,差异均有统计学意义(P<0.05)。观察组患者总有效率(93.33%)显著高于对照组(86.67%),差异有统计学意义(P<0.05)。观察组患者的不良反应发生率(23.33%)显著高于对照组(6.67%),差异有统计学意义(P<0.05)。结论:瑞舒伐他汀可显著降低急性脑梗死患者的炎症反应和血脂水平,抑制动脉粥样硬化斑块的形成,改善患者预后。较大剂量的瑞舒伐他汀治疗急性脑梗死疗效更好,可明显改善患者的神经功能缺损症状,并提高其日常生活能力。

OBJECTIVE： To observe the effectiveness and safety of different doses of rosuvastatin in the treatment of acute cerebral infarction. METHODS： Totally 120 patients with acute cerebral infarction were selected from Weifang Yidu Central Hospital during Jan. 2014-Dec. 2015, and then divided into observation group and control group according to admission order, with 60 cases in each group. Both groups received routine treatment as Sbuxuening injection 10 mL, iv, 1-2 times a day （or 20 mL added into 5% Glucose injection 250-500 mL, ivgtt, qd）＋Aspirin enteric-coated tablets 0.1 g,po,qd. Control group and observation group were additionally given Rosuvastatin calcium tablets 10 mg and 20 mg, po, qd （after supper）. Both groups were treated for 30 d. The levels of serum inflammatory factors （hs-CRP, TNF-α, IL-6）, blood lipid indexes （TC, TG, LDL-C）, neurological function and activity of daily life score were observed in 2 groups before and after treatment. The clinical efficacy and occurrence of ADR were recorded. RESULTS ： Before treatment, there was no statistical significance in the levels of hs-CRP, TNF-α, IL-6, TC, TG and LDL-C, NIHSS scores and Barthel index （BI） scores between 2 groups （P〉0.05）. After treatment, the levels of hs-CRP, TNF-α, IL-6, TC, TG and LDL-C, NIHSS scores in 2 groups were decreased significantly, while BI scores were decreased significantly, observation group were significantly better than those of control group, with statistical significance （P〈0.05）. Total response rate of observation group （93.33%） was significantly higher than that of control group （86.67%）, with statistical significance （P〈0.05）. The incidence of ADR in observation group （23.33%） was significantly higher than control group （6.67%）, with statistical significance （P〈0.05）. CONCLUSIONS： Rosuvastatin can significantly reduce the inflammatory reaction and blood lipid level of patients with acute cerebral infarction, inhibit the formation of atherosclerotic plaque and improve prognosis. The large dose of rosuvastatin have better efficacy for acute cerebral infarction and can significantly improve the symptom of neurological deficits and daily living ability of patients.