不同剂量阿托伐他汀对急性脑梗死合并大脑中动脉狭窄患者预后的影响  

Effects of different doses of atorvastatin on the prognosis of patients with acute cerebral infarction complicated with middle cerebral artery stenosis

作　　者：余科[1] 张志新[1] 韩玉乐 莫绮娴[1] 祁风[1] 

机构地区：[1]广州医学院荔湾医院神经内科,广东广州510170

出　　处：《中风与神经疾病杂志》2017年第3期268-270,共3页Journal of Apoplexy and Nervous Diseases

基　　金：广东省科技厅科技计划项目(项目编号:2014A020212688;项目名称:阿托伐他丁钙对大脑中动脉狭窄患者脑血管储备能力干预临床研究)

摘　　要：目的探讨不同剂量的阿托伐他汀对脑梗死合并大脑中动脉狭窄(cerebral artery stenosis,MCAS)患者预后的影响。方法 151例急性脑梗死合并MCAS的患者,随机分为大剂量(阿托伐他汀40 mg/d)组和小剂量(阿托伐他汀10 mg/d)组,同时积极治疗基础疾病。记录1 y内复发的脑梗死事件、采用改良mRS评分(Modified Rankin Scale,mRS)评定卒中神经功能。结果 151例患者中,大剂量组患者80例,小剂量组患者71例,1 y内再发脑梗死事件大剂量组4例(4/80,5%),小剂量组12例(12/71,16.9%),差异有统计学意义(P<0.05)。治疗随访1 y后,两组mRS评分及mRS评分差值比较差异均具有统计学意义(P<0.05)。结论大剂量阿托伐他汀治疗更能减少脑梗死合并大脑中动脉狭窄患者卒中复发,促进脑卒中患者神经功能恢复。Objective We aimed to investigate the effects of different doses of atorvastatin on the prognosis of the patients of ischemic stroke combined with cerebral artery stenosis（ MCAS）. Methods 151 patients with acute ischemic stroke companied with MCAS were enrolled,and divided into high-dose（ atorvastatin 40 mg/d） and low-dose（ atorvastatin 10mg/d） groups randomly. The endpoints during follow-up were recurrent stroke events. The neurological function was evaluated by Modified Rankin Scale（ mRS）. Results 80 patients were enrolled in high-dose group and 71 cases in low-dose group. During the 1-year follow-up,there were 4 and 12 recurrent stroke events in high-dose and low-dose groups respectively [5%（ 4/80） vs. 16. 9%（ 12/71） ],the difference was statistically significant（ P〈0. 05）. The values of mRS and mRS difference between the two groups were statistically significant in 1-year follow-up（ P〈0. 05）. Conclusion High dose atorvastatin therapy has more significant benefits in reducing stroke recurrence in patients with cerebral infarction and middle cerebral artery stenosis,promoting the recovery of neurological function.

关 键 词：急性脑梗死 阿托伐他汀 大脑中动脉狭窄 预后 疗效 

分 类 号：R743[医药卫生—神经病学与精神病学]