大剂量阿托伐他汀对急性脑梗死经静脉重组组织型纤溶酶原激活剂溶栓效果的影响  

Effect of high-dose atorvastatin on outcome of thrombolysis with recombinant tissue plasminogen activator in acute cerebral infarction

作　　者：丁张纳 厉向[2] 徐安聪 翁海旭 何国鑫 李绵绵 DING Zhangna;LI Xiang;XU Ancong(Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325200, China)

机构地区：[1]温州医科大学附属第三医院(瑞安市人民医院)重症医学科,325200 [2]温州医科大学附属第一医院神经内科

出　　处：《心电与循环》2019年第4期297-300,共4页Journal of Electrocardiology and Circulation

摘　　要：目的探讨大剂量阿托伐他汀对急性脑梗死经静脉重组组织型纤溶酶原激活剂(rt-PA)溶栓效果的影响。方法 130例4.5h内接受静脉溶栓治疗的急性脑梗死患者中,40例rt-PA静脉溶栓联合阿托伐他汀治疗(观察组),90例仅rt-PA静脉溶栓治疗(对照组)。比较两组患者静脉溶栓的安全性及90d预后,分析影响急性脑梗死溶栓预后的因素。结果两组患者性别、年龄、吸烟、饮酒、溶栓前美国国立卫生研究院卒中量表(NIHSS)评分、脑卒中史以及患有糖尿病、高血压、动脉粥样硬化、心房颤动的比例等方面比较,差异均无统计学意义(均P>0.05)。观察组第90天溶栓预后良好率(70.0%)明显高于对照组(45.6%),差异有统计学意义(P<0.05)。二元logistic回归分析显示溶栓前NIHSS评分(OR=0.68,95%CI:0.581~0.796)是急性脑梗死患者静脉溶栓预后的危险因素,溶栓时联合使用大剂量阿托伐他汀(OR=2.848,95%CI:1.072~7.564)是急性脑梗死患者静脉溶栓预后的保护因素。结论在急性脑梗死患者静脉溶栓时应用大剂量阿托伐他汀可以改善患者预后。Objective To evaluate the effect of high-dose atorvastatin on outcome of thrombolysis with recombinant tissue plasminogen activator(rt-PA) in acute cerebral infarction(ACI). Methods Date of 130 patients underwent intravenous thrombolysis within 4.5 hours of ACI were analyzed. Of them, 40 patients received atorvastatin with rt-PA intravenous thrombolysis(observation group) while the other 90 patients were not(control group). The safety and 90 days outcome of intravenous thrombolysis were compared between the two groups. The factors influencing the prognosis of ACI were analyzed. Results There was no significant difference of gender, age, smoking, drinking, National Institutes of Health Stroke Scale(NIHSS) score, history of stroke, proportion of diabetes, hypertension, atherosclerosis, and atrial fibrillation between the two groups(all P >0.05). The ratio of better outcome of thrombolysis at 90 th day was significantly higher in observation group(70.0%) than in control group(45.6%)(P <0.05). Binary logistic regression analysis showed that NIHSS score before thrombolysis was a risk factor(OR=0.68, 95% CI:0.581~0.796) and high dose atorvastatin was a protective factor(OR=2.848, 95% CI:1.072~7.564) for the outcome of intravenous thrombolysis in patients with ACI.Conclusion Application of high dosage of atorvastatin during intravenous thrombolysis may improve outcome of patients with ACI.

关 键 词：急性脑梗死 静脉溶栓 阿托伐他汀 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]