强化降脂对缺血性脑卒中患者血脂及颈动脉粥样硬化的影响  

Effect of intensive lipid lowering on blood-fat and carotid atherosclerosis in patients with cerebral ischemic stroke

作　　者：郑建新[1] 孙顺成[1] 刘俊超[1] 

机构地区：[1]漯河医学高等专科学校第二附属医院神经内科

出　　处：《中风与神经疾病杂志》2013年第1期25-27,共3页Journal of Apoplexy and Nervous Diseases

摘　　要：目的观察强化降脂治疗对缺血性卒中患者血脂及颈动脉粥样硬化的影响。方法随机将102例有血脂异常及颈动脉粥样硬化的缺血性卒中患者分为阿托伐他汀常规治疗组(20mg/d)与强化降脂治疗组(40mg/d),每组51例,分别于用药前、用药后6m检测血脂,颈动脉超声测定颈动脉内膜中层厚度(CIMT)变化。结果治疗后6m,两组总胆固醇(TC)、低密度脂蛋白(LDL-C)、甘油三脂(TG)水平均降低,高密度脂蛋白胆固醇(HDL-C)均有升高,强化降脂组较常规降脂组血脂变化更明显(P<0.05或P<0.01),强化降脂组CIMT、斑块面积较常规治疗组降低更明显(P<0.05),强化降脂组缺血性脑血管病复发率较常规组明显降低(P<0.05),两组不良反应发生率比较无统计学意义。结论强化降脂治疗能有效改善缺血性卒中患者血脂水平,有效延缓和逆转颈动脉粥样硬化斑块,减少缺血性脑血管的复发率,且安全性良好。Objective To observe the effect of intensive lipid-lowering therapy on blood-fat and carotid atherosclero- sis in patients with cerebral ischemic stroke. Methods 102 patients with dyslipidemia and carotid atherosclerosis were randomly divided into atorvastatin routine treatment group （20mg/d） and intensive lipid-lowering treatment group （ 40mg/ d） ,51 cases patients in each group. Blood lipid was tested and the carotid intima-media thickness（CIMT） change was de- termined before and after 6 months respectively. Results 6 months after treatment, the two groups of total cholesterol （ TC ）, low density lipoprotein （ LDL-C ）, triglycerides （TG） levels were reduced, high-density lipoprotein cholesterol （ HDL- C） were raised, Intensive lipid-lowering group compared with conventional lipid-lowering group, blood fat change was more obvious（P 〈0.05 or P 〈0.01 ）. The CIMT and plaque area in Iintensive lipid-lowering group were lowerer than the con- ventional treatment group obviously（P 〈0.05）. The recurrence rate of ischemic cerebrovascular disease in intensive lipid- lowering group was lowerer than conventional group significantly（ P 〈 0.05 ）. Adverse reaction rate was no statistical signifi- cance in two groups. Conclusion Intensive lipid-lowering therapy can effectively improve blood lipid level, effectively de- lay and reverse carotid atherosclerotic plaques, and reduce ischemic cerebrovascular recurrence rate of the ischemic stroke patients with safety.

关 键 词：强化降脂 缺血性卒中 颈动脉粥样硬化 血脂 

分 类 号：R743.3[医药卫生—神经病学与精神病学]