瑞舒伐他汀与阿托伐他汀对脑小血管病患者血脂、血小板聚集率、炎症因子水平及认知功能的比较

Comparison of rosuvastatin with atorvastatin on levels of blood lipid,platelet aggregation rate,inflammatory factors and cognitive function in patients with cerebral small vessel disease

目的比较瑞舒伐他汀与阿托伐他汀对脑小血管病患者(CSVD)血脂、血小板聚集率、炎症因子及认知功能的影响。方法选取武警北京市总队医院2017年1月至2018年1月收治的CSVD患者96例,按随机数字表法分为试验组(48例)和对照组(48例)。两组入院后均给予基础治疗,对照组采用阿托伐他汀治疗,试验组采用瑞舒伐他汀治疗,连续治疗6个月。比较治疗前后两组总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、血小板聚集率、简易精神状态量表(MMSE)和蒙特利尔认知量表(MOCA)评分、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、C反应蛋白(CRP)变化;记录治疗期间两组不良反应发生率。结果治疗后,两组血脂指标TC、TG、LDL-C水平低于治疗前(P<0.05),且试验组血脂指标TC、TG、LDL-C水平较对照组低(均P<0.05)。治疗后,两组血小板聚集率低于治疗前(P<0.05),MMSE、MOCA评分高于治疗前(P<0.05),且试验组血小板聚集率较对照组低(P<0.05),认知功能指标MMSE、MOCA评分较对照组高(P<0.05)。治疗后,两组炎症因子指标TNF-α、CRP、IL-6水平低于治疗前(P<0.05),且试验组炎症因子指标TNF-α、CRP、IL-6水平较对照组低(P<0.05)。试验组不良反应发生率(14.58%)与对照组(8.33%)比较差异无统计学意义(P>0.05)。结论与阿托伐他汀相比,瑞舒伐他汀在改善CSVD患者认知功能、降脂、抑制血小板聚集、抗炎方面的效果更优,且安全性较好。

Objective To compared the effect of rosuvastatin and atorvastatin on blood lipid,platelet aggregation rate,inflammatory factors and cognitive function in patients with cerebral small vessel disease(CSVD).Methods 96 CSVD patients in Beijing Armed Police Corps Hospital from January 2017 to January 2018 were selected and randomly divided into experimental group(48 cases)and control group(48 cases).The control group was treated with atorvastatin,and the experimental group was treated with rosuvastatin for 6 months.The changes of total cholesterol(TC),triacylglycerol(TG),low density lipoprotein cholesterol(LDL-C),platelet aggregation rate,scores of Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MOCA)scores,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)before and after treatment between the two groups were compared;The incidence of adverse reactions in the two groups was recorded.Results After6 months of treatment,the levels of TC,TG and LDL-C in both groups were lower than those of before treatment(P<0.05),and the levels of TC,TG and LDL-C in the experimental group were lower than those of control group(;A<0.05).The platelet aggregation rate in both groups was lower than that of before treatment(P<0.05),MMSE and MOCA scores were higher than those of before treatment(P<0.05),and the platelet aggregation rate in the experimental group was lower than that of control group(P<0.05),scores of cognitive function indexes MMSE,MOCA were higher than those of control group(P<0.05).The levels of TNF-α,CRP and IL-6 were lower than those of before treatment(P<0.05),and the levels of TNF-α,CRP and IL-6 in the experimental group were lower than those of control group(P<0.05).The incidence of adverse reactions in the experimental group(14.58%)was not significantly different from that in the control group(P>0.05).Conclusion Compared with atorvastatin,rosuvastatin has better effect in improving cognitive function,reducing blood fat,inhibiting platelet aggregation and anti-inflammatory in patients with CSVD,and has higher safety.