阿伐他汀钙对老年脑梗死病人血脂水平及颈动脉粥样硬化的疗效

The effects of avastatin on serum lipid level in elderly patients with cerebral infarction and the curative effect on carotid atherosclerosis

目的探讨阿伐他汀钙对老年脑梗死病人血脂水平以及颈动脉粥样硬化的临床效果。方法回顾性分析2015年2月至2016年2月驻马店市第四人民医院和驻马店市第一人民医院收治的急性脑梗死病人46例。按照治疗及随访期间是否服用阿伐他汀钙,将病人分为对照组及治疗组两组。对照组采用常规的抗血小板聚集以及对症支持治疗,治疗组在此基础上予以口服阿伐他汀钙,20 mg/d。对病人进行治疗随访,比较治疗前以及治疗半年后两组病人的血脂水平以及颈动脉内膜中层厚度以及内膜斑块的面积。结果与治疗前比较,治疗组与对照组治疗半年后的三酰甘油,总胆固醇以及低密度脂蛋白(LDL),颈动脉内膜中层厚度显著降低,高密度脂蛋白(HDL)显著增高,差异有统计学意义(P <0. 05);颈动脉斑块面积有所减少,但差异无统计学意义(P> 0. 05)。治疗半年后,治疗组的三酰甘油,总胆固醇以及低密度脂蛋白(LDL)[(1. 2±0. 2、3. 8±0. 4、2. 4±0. 3) mmol/L]低于对照组[(1. 4±0. 2、4. 7±0. 4、3. 0±0. 3) mmol/L],HDL[(1. 4±0. 3) mmol/L]显著高于对照组[(1. 2±0. 2) mmol/L],差异有统计学意义(P <0. 05);颈动脉斑块厚度和面积[(1. 3±0. 2) mm、(22. 1±9. 0) mm2]与对照组[(1. 5±0. 5) mm、(26. 2±10. 0) mm2]比较均有所减少,差异有统计学意义(P <0. 05)。结论阿伐他汀钙能有效的降低老年急性脑梗死病人的血脂水平,减轻颈动脉内膜中层厚度,改善颈动脉粥样硬化的程度。

Objective To explore the clinical effect of atorvastatin calcium on levels of serum lipid and carotid atherosclerosis in elderly patients with cerebral infarction.Methods Forty six cases of patients with acute cerebral infarction admitted in department of neurology from February 2015 to February 2016 were analyzed retrospectively.Patients were divided into treatment group and control group according to whether atorvastatin calcium was taken or not during treatment and follow-up.The control group received conventional antiplatelet aggregation and symptomatic support and the patients in the control group were treated with atorvastatin calcium(20 mg/day)on the basis of this therapy.The patients were followed up for treatment.Compared the levels of serum lipid and the thickness of carotid intima-media and plaque area before and after treatment in the two groups.Results Compared with those before treatment,the carotid intima-media thickness of triglyceride,total cholesterol and low density lipoprotein(LDL),in the treatment group and the control group decreased significantly after six months of treatment,while the(HDL)of the high-density lipoprotein increased significantly(P<0.05);Carotid plaque area decreased,but the difference was not statistically significant(P>0.05).Six months after treatment,triglyceride,total cholesterol and(LDL)(of low density lipoprotein(LDL)in the treatment group were significantly lower than those in the control group[(1.2±0.2,3.8±0.4,2.4±0.3)mmol/L],and were significantly lower than those in the control group[(1.4±0.2,4.7±0.4,3.0±0.3)mmol/L],HDL[(1.4±0.3)mmol/L]vs.[(1.2±0.2)mmol/L](P<0.05).The thickness and area of carotid plaque[(1.3±0.2)mm,(22.1±9.0)mm 2]decreased compared with the control group[(1.5±0.5)mm,(26.2±10.0)mm 2],The difference was statistically significant.(P<0.05).Conclusions Atorvastatin calcium can effectively reduce the blood lipid levels of elderly patients with acute cerebral infarction,reduce carotid intima-media thickness and improve the degree of carotid atherosclerosis.