高剂量与常规剂量阿托伐他汀对急性脑梗死患者颈动脉粥样硬化及神经功能的影响对比

Comparison of Effect of High Dose and Conventional Dose of Atorvastatin on Carotid Atherosclerosis and Nerve Function in Patients with Acute Ce⁃rebral Infarction

目的对比分析高剂量与常规剂量阿托伐他汀治疗急性脑梗死(Acute Cerebral Infarct,ACI)患者对颈动脉粥样硬化及神经功能的影响。方法便利选择寿光市人民医院于2021年3月—2023年3月收治的88例ACI患者为研究对象,按随机数表法分为两组,每组44例。两组均予以阿托伐他汀治疗,对照组按照常规剂量(20 mg/次,1次/d),观察组按照高剂量(40 mg/次,1次/d),均治疗1个月。比较两组神经功能、临床疗效、颈动脉粥样硬化指标、炎性因子水平、血脂水平、不良反应。结果观察组治疗总有效率(95.45%)高于对照组(81.82%),差异有统计学意义(χ^(2)=4.062,P<0.05)。治疗前,两组神经功能、颈动脉粥样硬化指标、炎性因子水平、血脂水平比较,差异无统计学意义(P均>0.05);治疗后,观察组美国国立卫生研究院卒中量表评分、颈动脉内中膜厚度、斑块面积均低于对照组,差异有统计学意义(P均<0.05)。观察组高敏C反应蛋白、白细胞介素-8、白细胞介素-1β、肿瘤坏死因子-α、总胆固醇、甘油三酯、低密度脂蛋白胆固醇均低于对照组,差异有统计学意义(P均<0.05)。观察组高密度脂蛋白胆固醇高于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论高剂量阿托伐他汀治疗ACI效果较常规剂量好,能够更为显著改善神经功能、颈动脉粥样硬化,减轻炎症反应,且不会明显增加不良反应。

Objective To compare and analyze the effects of high-dose and conventional-dose atorvastatin on carotid atherosclerosis and neurological function in patients with acute cerebral infarction(ACI).Methods A total of 88 ACI patients admitted to Shouguang People's Hospital from March 2021 to March 2023 were conveniently selected as the research objects and divided into two groups according to the random number table method,with 44 cases in each group.Both groups were treated with atorvastatin.The control group was treated with conventional dose(20 mg/time,1 time/d),and the observation group was treated with high dose(40 mg/time,1 time/d)for 1 month.The neurological function,clinical efficacy,carotid atherosclerosis indicators,inflammatory factor levels,blood lipid levels,and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group(95.45%)was higher than that in the control group(81.82%),and the difference was statistically significant(χ^(2)=4.062,P<0.05).Before treatment,there were no statistically significant differences in neurological function,carotid atherosclerosis indicators,inflammatory factor levels and blood lipid levels between the two groups(all P>0.05);after treatment,the National Institutes of Health Stroke Scale score,carotid intima-media thickness and plaque area in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).The levels of high-sensitivity C-reactive protein,interleukin-8,interleukin-1β,tumor necrosis factor-α,total cholesterol,triglyceride and low-density lipoprotein cholesterol in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).The high density lipoprotein cholesterol in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Con-clusion The effect of high dose atorvastatin in the treatment of ACI is better than that of conventional dose,which can significantly improve nerve function,carotid atherosclerosis,reduce inflammation,and do not significantly increase adverse reactions.