阿托伐他汀降低急性脑梗死出血转化后癫痫发作的相关性研究

Study on the relationship between Atto vastatin and epilepsy after acute cerebral infarction hemorrhage transformation

目的探讨阿托伐他汀降低急性脑梗死出血转化后癫痫发作的风险。方法选取2012年1月至2017年1月在延安大学威阳医院收治的首发急性脑梗死后出血转化的患者660例,按照是否应用阿托伐他汀钙胶囊及其剂量分为4组,0 mg/d组(未应用组)、10 mg/d组、20 mg/d组、40 mg/d组,各165例。比较发病后2年各组卒中后癫痫发生率、发作类型及用药安全性。结果未应用组发生癫痫12例(7.2%),10 mg/d组9例(5.4%),20 mg/d组5例(3.0%),40 mg/d组2例(1.2%),差异具有统计学意义(P<0.05)。各组症状性脑出血量増加及脑水肿加重、肝肾功明显异常、肌酶明显异常发生率比较差异无统计学意义,且各组均未发生致死性脑出血量增加。结论在卒中发病24 h内应用阿托伐他汀可以降低急性脑梗死出血转化后癫痫发作的风险,在一定范围内(0~40 mg/d),随着阿托伐他汀钙剂量的增加,卒中后癫痫发生率降低,且各不同剂量均相对安全。

Objective To explore the effect of Atto vastatin on the risk of epilepsy after acute cerebral infarction hemorrhage transformation.Methods According to whether or not to use Atto vastatin calcium capsule and its dosage,660 patients who were treated in Xianyang Hospital of Yan'an University from January 2012 to January 2017 were divided into four groups:0 mg/d group(non-application group),10 mg/d group,20 mg/d group and 40 mg/d group,with 165 cases in each group.The incidence,seizure type and drug safety of post-stroke epilepsy in each group were compared 2 years after onset.Results 12 cases of non-application group(7.2%),9 cases of 10 mg/d(5.4%),5 cases of 20 mg/d(3.0%)and 2 cases of 40 mg/d(1.2%).The difference was statistically significant(P<005).There was no significant difference in the amount of symptomatic cerebral hemorrhage,the aggravation of brain edema,the obvious abnormality of liver and kidney function and the abnormal incidence of muscle enzyme in each group,and there was no increase in the amount of fatal cerebral hemorrhage in each group.Conclusion The use of Atto vastatin within 24 hours of stroke can reduce the risk of epilepsy after acute cerebral infarction.Within a certain range(0-40 mg/d),with the increase of the dose of statins,the incidence of post-stroke epilepsy decreased,and different doses were relatively safe.