不同剂量阿托伐他汀钙治疗脑梗死急性期的效果分析

Effect analysis of Atorvastatin Calcium in different doses in the treatment of acute cerebral infarction

目的探讨不同剂量阿伐他汀钙治疗脑梗死急性期的效果。方法选择2014年6月~2016年7月在我院接受治疗的急性期脑梗死患者150例,依据阿伐他汀钙使用不同分为三组(10 mg组、20 mg组、40 mg组),每组50例。三组患者均用药90 d,对比分析其用药前、用药30 d及90 d的低密度脂蛋白胆固醇(LDL)、总胆固醇(TC)、三酰甘油(TG)、超敏C-反应蛋白(hs-CRP)、内中膜厚度(IMT)、高密度脂蛋白胆固醇(HDL)、卒中量表(NIHSS)、肌酐(Cr)、尿酸(UA)、尿素氮(BUN)、白细胞(WBC)的变化。结果用药后30 d、90 d与用药前相比,三组患者的LDL、TC、TG水平均显著下降(P<0.05);而治疗后90 d,20 mg组和40 mg组患者的LDL与TC水平与10 mg组比较,差异有统计学意义(P<0.05),三组HDL水平具有明差异(P<0.05),而三组患者TG水平差异无统计学意义(P>0.05)。治疗后30 d、90 d,三组患者NIHSS评分与治疗前比较,差异有统计学意义(P<0.05);治疗后90 d,20mg组和40 mg组与10 mg组评分比较,差异有统计学意义(P<0.05),而20 mg组和40 mg组比较,差异无统计学意义(P>0.05)。治疗后30 d,20 mg组和40 mg组患者的hs-CRP水平和10 mg组相比差异有统计学意义(P<0.05),但20 mg组和40 mg比较,差异无统计学意义(P>0.05)。而90 d时三组间相比差异无统计学意义(P>0.05)。三组患者治疗前后IMT、Cr、UA、BUN、WBC的比较,差异无统计学意义(P>0.05)。结论阿托伐他汀钙剂量为20 mg时可以较安全有效治疗急性脑梗死,并降低hs-CRP水平。

Objective To investigate the effect of different doses of Atorvastatin Calcium in the treatment of acute cere- bral infarction （ACI）.Methods From June 2014 to July 2016,150 ACI patients admitted to our hospital were selected as research subjects.According to different dosage of atorvastatin calcium,they were evenly divided into three groups （10 mg,20 mg,and 40 mg） 50 cases in each group.The medication was continued for 90 days.The indicators of low density lipoprotein cholesterol （LDL）,total cholesterol （TC）,triglyceride （TG）,high sensitivity C-reactive protein （hs-CRP）,inti- ma-medial thickness （IMT）,high density lipoprotein cholesterol （HDL）,stroke scale （NIHSS）,creatinine （Cr）,uric acid （UA）,blood urea nitrogen （BUN）,and white blood cell （WBC） were compared before treatment,30 day,and 90 day after treatment.Results The 30 day and 90 day treatments was compared with prior treatment,the levels of LDL,TC,and TG in three groups were all decreased significantly （P〈O.05）.However,after the treatment of 90 days,the LDL and TC levels in the 20 mg and 40 mg groups were significantly different than those in the 10 mg group （P〈0.05）.There was great differ- ence in HDL level among three groups （P〈0.OS）,while for TG level,it was not significant （P〉0.05）.After treatment for 30 and 90 days,the NIHSS scores were displayed statistical differences in comparison with that prior treatment among three groups （P〈0.05）.The score in 20mg and 40 mg groups was greatly different from that in lOmg group after 90 day treat- ment,but for the comparison of 20 mg and 40 mg groups,they were not obvious （P〉0.05）.After 30 day therapy,thehs-CRP level in 20 mg and 40 mg groups was displayed a statistical difference compared with that in 10mg group （P〈0.05）, but no statistical significance between 20 mg group and 40 mg group （P〉0.05）.On day 90,there was no significant difference in hs-CRP level among three groups （P〉0.05）.No significant change was detected in IMT,Cr, UA,BUN,or WBC before and after treatment among three groups （P〉0.05）.Conclusion Atorvastatin calcium in 20 mg can treat ACI in safe and effective,also reduces the hs-CRP level.