强化阿托伐他汀联合阿替普酶静脉溶栓治疗急性缺血性脑卒中的疗效及安全性

The effect and safety of intensive statin combined with Alteplase intravenous thrombolysis on acute ischemic stroke

[目的]研究强化阿托伐他汀联合阿替普酶静脉溶栓对急性缺血性脑卒中的疗效及安全性。[方法]将99例发病4.5 h内的急性缺血性脑卒中患者随机分为两组。观察组50例,阿替普酶静脉溶栓后给予阿托伐他汀40 mg/d,口服14 d后改为20 mg/d,共90 d,同时给予缺血性卒中的基础治疗;对照组49例,阿替普酶静脉溶栓后给予阿托伐他汀20mg/d,口服90 d,同时给予缺血性卒中的基础治疗。观察分析两组患者14、90 d的NIHSS评分、mRS评分、血清总胆固醇水平和不良反应。[结果]两组患者治疗14、90 d的NIHSS评分及mRS评分较发病时均明显改善(P<0.05),观察组疗效优于对照组(P<0.05)。观察组患者胆固醇水平较对照组降低(P<0.05)。两组患者均未发生严重不良反应。[结论]强化阿托伐他汀联合阿替普酶静脉溶栓可明显改善急性缺血性脑卒中患者的功能预后。

[Objective]To analysize the effect and safety of intensive Atorvastatin combined with Alteplase intravenous thrombolysis on acute ischemic stroke.[Methods]99 inpatients who within 4.5 hours onset of acute ischemic stroke were randomly divided into two groups.Observation group(n=50)were treatd with Atorvastatin(40 mg/d)orally for 14 d immediately after Alteplase intravenous thrombolytic therapy.After that,20 mg/d was given for 90 d totally,and basic treatment for ischemic stroke was given at the same time.In the control group(n=49),immediately after Alteplase intravenous thrombolysis,Atorvastatin 20 mg/d was given orally for 90 d,and the same basic medication for ischemic stroke was given at the same time.The NIHSS score and mRS score and the levels of total cholesterol and the incidence of adverse reactions of the two groups,14 d and 90 d after treatment were observed.[Results]The NIHSS scores and mRS scores of both groups were significantly improved 14 d and 90 d after treatment(P<0.05).The scores of observation group was significantly lower than those of control group(P<0.05).The levels of total cholesterol in observation group was lower than those in control group(P<0.05).No serious adverse reaction was found in both two groups.[Conclusion]Intensive statins combined with Alteplase intravenous thrombolysis can effectively improve the neurological prognosis of patients with acute ischemic stroke.