阿托伐他汀钙对症状性大脑中动脉狭窄患者脑血管储备能力影响的研究

The effect of atorvastatin on cerebrovascular reservee capacity in patients with symptomatic middle cerebral artery stenosis

目的探讨阿托伐他汀钙对症状性大脑中动脉狭窄患者脑血管储备能力的影响。方法连续纳入2015年9月-2017年4月在广州医科大学附属第三医院荔湾医院神经内科住院就诊的症状性MCA狭窄患者(包括单侧和双侧狭窄),随机分成低剂量组(阿托伐他汀钙10 mg/d)及高剂量组(阿托伐他汀钙40 mg/d)。治疗3 m后,比较阿托伐他汀钙对脑血管储备能力的影响。结果共纳入症状性MCA狭窄患者208例,其中低剂量组102例,高剂量组106例。(1)低剂量组治疗前CVR为(18. 13±4. 8)%,治疗后为(21. 01±3. 9)%;高剂量组治疗前CVR为(17. 88±4. 9)%,治疗后为(25. 62±5. 5)%,低剂量组及高剂量组治疗前后CVR差异均有统计学意义(P<0. 05);(2)低剂量组治疗前后CVR差值(2. 89±4. 0)%,与高剂量组(7. 74±6. 7)%相比,两者差异有统计学意义(P <0. 05)。结论阿托伐他汀钙能改善症状性MCA狭窄患者的脑血管储备能力,强化剂量疗效更佳。

Objective To investigate the effects of atorvastatin on cerebrovascular reserve capacity in patients with symptomatic middle cerebral artery stenosis. Methods Symptomatic MCA stenosis patients( including unilateral and bilateral stenosis) in the Liwan Hospital of the Third Affiliated Hospital of Guangzhou Medical University from September 2015 to April 2017 were enrolled. Patients were randomly divided into low-dose group( atorvastatin calcium 10 mg/d) and highdose group( atorvastatin calcium 40 mg/d). After 3 months of treatment,the effects of statins on cerebrovascular reserve capacity were analyzed and compared. Results A total of 208 patients with symptomatic MCA stenosis were included,including 102 patients in the low-dose group and 106 patients in the high-dose group.( 1) In low-dose group,the mean CVR was( 18. 13 ± 4. 8)% before treatment and( 21. 01 ± 3. 9)% after treatment;In high-dose group,the mean CVR was( 17. 88 ±4. 9)% before treatment and( 25. 62 ± 5)% after treatment. CVR were statistically significant different before and after treatment in each group with different doses of atorvastatin calcium( P < 0. 05).( 2) The change of CVR is( 2. 89 ± 4. 0)%in lowe-dose group and( 7. 74 ± 6. 7)% in high dose group,the difference was statistically significant( P < 0. 05).Conclusion Atorvastatin calcium can improve the cerebrovascular reserve capacity of patients with symptomatic middle cerebral artery stenosis with the most significant effects found in the high dose treated group.