不同剂量阿托伐他汀钙治疗急性脑梗死临床观察

Clinical observation of different doses of statins in the treatment of patients with acute cerebral infarction

目的比较急性脑梗死患者应用不同剂量阿托伐他汀钙对血脂、超敏C反应蛋白(hs-CRP)及颈动脉粥样斑块的影响。方法选取商丘市中心医院2015-03—2016-09符合入选条件的急性脑梗死患者84例,采用随机数字表法分为对照组和观察组各42例,在标准脑梗死治疗基础上,对照组给予阿托伐他汀钙片20mg,观察组给予阿托伐他汀钙片40 mg,1次/d。入院时及治疗3个月后检测血脂、hs-CRP水平,彩色多普勒超声检查颈动脉粥样硬化斑块情况,采用NIHSS评定神经功能缺损程度,并统计不良反应情况。结果与治疗前比较,2组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和hs-CRP水平均显著降低(P<0.05),且观察组低于对照组(P<0.05);治疗3个月时,2组颈动脉内中膜厚度(IMT)、斑块积分及NIHSS评分均较前减少,观察组减少程度更大,差异有统计学意义(P<0.05)。2组不良反应差异无统计学意义(P>0.05)。结论阿托伐他汀可以降血脂、hs-CRP水平,具有稳定及缩小颈动脉粥样斑块、改善神经功能缺损程度的作用,40mg阿托伐他汀效果更佳,不良反应无明显增加,有较好的安全性。

Objective To compare the effects of different doses of atorvastatin on serum lipids, hypersensitive C-reactive protein（hs-CRP） and carotid atheroraatous plaques in patients with acute cerebral infarction. Methods From March 2015 to Sep- tember 2016,84 patients of acute cerebral infarction were enrolled in our hospital, and were randomly divided into control group （42 cases） and observation group （42 cases）. On the basis of the standard treatment of cerebral infarction, the control group was given atorvastatin tablet of 20 rag,the observation group was given Atorvastatin tablet of 40 mg, once a day. On admission and 3 months after treatment, the levels of hs-CRP, serum lipids were measured;and the intima-raedia thickness（IMT）, plaque score were examined by eolo Doppler as well. Assessment of neurological deficits by NIHSS. The adverse reactions of two groups were recorded. Results The levels of total cholesterol （TC）, triglyceride （TG）, low-density lipoprotein cholesterol （LDL-C） and hs- CRP were reduced in every group after treatraent（P〈0.05）, and the observation group was significant than that in control group （P〈0.05）. The IMT, plaque score, and NIHSS score of the patients were reduced after treatment, and the observation group was statistically lower than that in the control group （P〈0.05）. The adverse reactions were no significant difference between the two groups. Conclusion Atorvastatin can reduce the levels of serum lipids and hs-CRP, stabilize plaque and improve neurological function degree. The effect of 40 mg atorvastatin doses is better,no significant increase in adverse reactions.