阿托伐他汀与匹伐他汀对急性大动脉粥样硬化型脑梗死患者颈动脉斑块、血脂水平及安全性的影响

The effects and safety of atorvastatin and pitavastatin on carotid plaque and blood lipid levels in patients with acute large atherosclerotic cerebral infarction

目的:比较阿托伐他汀与匹伐他汀对急性大动脉粥样硬化型脑梗死(ALACI)的疗效。方法:选取2018年12月至2019年12月收治的ALACI患者78例,随机分为A组和B组,每组39例。两组均接受常规治疗,A组加用匹伐他汀,B组加用阿托伐他汀,比较两组治疗前后神经功能、颈动脉斑块、血脂水平,并记录不良反应发生情况。结果:治疗6个月后,两组美国国立卫生研究院卒中量表(NIHSS)、Barthel指数(BI)评分、颈动脉中层厚度、粥样硬化斑块面积均优于治疗前(P<0.05),但组间比较差异无统计学意义(P>0.05);治疗6个月后,两组甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)均优于同组治疗前(P<0.05),而组间比较,B组TG下降更明显,A组LDL-C下降更明显(P<0.05);A组不良反应发生率为10.26%,较B组的30.77%明显降低(P<0.05)。结论:阿托伐他汀与匹伐他汀可有效改善ALACI患者神经功能,减少颈动脉粥样硬化斑块,均具有良好调脂效果,但阿托伐他汀对TG下调作用优于匹伐他汀,匹伐他汀对LDL-C下调作用优于阿托伐他汀,且匹伐他汀安全性更高。

Objective:To compare the clinical effects of atorvastatin and pitavastatin in the treatment of acute large atherosclerotic cerebral infarction(ALACI).Methods:A total of 78 patients with ALACI in our hospitalfrom December 2018 to December 2019 were selected,and randomly divided into group A and group B,with 39 patients in each group.The patients in group A received conventional treatment and pitavastatin,while those in group B received conventional treatment and atorvastatin.The neurological function,carotid plaque and blood lipid levels before and after treatment were compared,and the adverse reactions were recorded.Results:The National Institutes of Health Stroke Scale(NIHSS)score,Barthel index(BI),carotid artery middle layer thickness and atherosclerotic plaque area after 6 months of treatment in both groups were significantly better than those before treatment(P<0.05),but no significant difference was found between the two groups(P>0.05).The triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL-C)after 6 months of treatment in both groups were significantly better than those before treatment(P<0.05).The TG level was lower in group B,and the LDL-C level was lower in group A(P<0.05).The incidence of adverse reactions in group A was 10.26%,which was significantly lower than that in group B(30.77%)(P<0.05).Conclusion:Both atorvastatin and pitavastatin can improve the neurological function and decrease carotid atherosclerotic plaques and blood lipidin ALACI patients;atorvastatin has more significant effect on TG reduction,while pivastatin possesses more obvious effect on LDL-C reduction and higher safety.