阿托伐他汀干预对急性脑梗死患者临床疗效及预后的影响  

Clinical Efficacy and Prognostic Value of Atorvastatin on Patients with Acute Cerebral Infarction

作　　者：杨平[1] 张丽芳[2] 顾淑娥[1] 马大伟[1] 成江[3] 杜彦辉[3] 

机构地区：[1]宁夏医科大学,银川750004 [2]宁夏医科大学总医院VIP科,银川750004 [3]宁夏医科大学总医院神经内科,银川750004

出　　处：《宁夏医科大学学报》2011年第6期543-546,561,共5页Journal of Ningxia Medical University

基　　金：宁夏医科大学校级科研项目(97)

摘　　要：目的探讨阿托伐他汀对急性脑梗死患者的临床疗效及早期预后。方法选择入院的急性脑梗死患者70例,随机分为对照组(常规治疗)和阿托伐他汀组(常规治疗的基础上加用阿托伐他汀钙片20mg.d-1,连续治疗6个月),分别于治疗前、治疗后1个月、治疗后3个月检测血脂、C反应蛋白(CRP)、双侧颈动脉B超、颈动脉内膜中层厚度(IMT);对伴有颈动脉斑块的脑梗死患者测量斑块面积及斑块Crouse积分,并在治疗6个月进行生活自理量表(ADL)评分。结果 (1)阿托伐他汀组治疗1个月后比治疗前低密度脂蛋白胆固醇(LDL-C)和CRP的水平降低(P均<0.05),对照组CRP水平也比其治疗前降低(P<0.05),但阿托伐他汀组降低更明显(P<0.05)。阿托伐他汀组治疗3个月后比治疗前TC和LDL-C及CRP水平降低(P均<0.01),阿托伐他汀组治疗3个月后比治疗1个月后TC、LDL-C和CRP水平降低(P均<0.05),但治疗3个月后CRP水平在两组间比较差异无统计学意义(P>0.05)。(2)两组治疗1个月后与治疗前IMT比较差异均无统计学意义(P>0.05),阿托伐他汀组治疗3个月后比其治疗前、治疗1个月后IMT均降低(P均<0.01);两组斑块面积在各时间点之间比较差异均无统计学意义(P>0.05);阿托伐他汀组治疗3个月后Crouse积分较其治疗前及治疗1个月后均降低(P均<0.05)。(3)阿托伐他汀组治疗6个月后较对照组ADL评分增加(P<0.05)。结论阿托伐他汀在早期对急性脑梗死患者有降脂和抗炎的作用,并能稳定或逆转颈动脉斑块,改善患者早期预后。Objective To investigate the clinical efficacy and early prognostic value of atorvastatin in patients with acute cerebral infarction.Methods 70 patients with acute cerebral infarction were randomly divided into control group and atorvastatin group.The patients in the control group received conventional therapy,while those in the atorvastatin group was administrated orally with 20mg of Atorvastatin.The indices of total cholesterol（TC）,triglyceride（TG）,lowerdensity lipoprotein-cholesterol（LDL-C）,high density lipoprotein-cholesterol（HDL-C）,C-reactive protein（CRP）,carotid artery ultrasound and the carotid artery intima-media thickness（IMT） were compared respectively in the groups before and after treatment of the first month and the third month.Plaque area and plaque Crouse points were detected in patients with cerebral infarction.All patients were followed up for 6 months.Results（1） After 1 month treatment,LDL-C and CRP levels in atorvastatin group significantly reduced compared with those before treatment（P0.01） and CRP also decreased in the control group（P0.05）.After 3 months treatment in the atorvastatin group,TC and LDL-C and CRP significantly reduced compared with those before treatment and after 1 month treatment（P0.05）.（2）There was no significant difference on IMT between the two groups before treatment（P0.05）,and after 1 month treatment the above was also no significant difference（P0.05）.After 3 months treatment in the atorvastatin group,the IMT significantly decreased（P0.01）;Plaque area was no significant difference between the two groups（P0.05）;Crouse score in the atorvastatin group were significantly lower than that in the control group（P0.05）.（3）ADL score significantly increased in patients of atorvastatin group after six months treatment（P0.05）.Conclusion Atorvastatin had early lipid-lowering and antiinflammatory effects on patients with acute cerebral infarction.It could stabilize or reverse the carotid artery plaque and improve th

关 键 词：急性脑梗死 阿托伐他汀 颈动脉超声 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]