强化他汀治疗对急性脑梗死疗效影响及CISS分型的关系研究  

Study on the effects of intensive atorvastatin treatment on acute cerebral infarction and its relationship with CISS

作　　者：刘满卓 赵素霞[1] 李嘉民[1] LIU Manzhuo;ZHAO Suxia;LI Jiamin(Department of Neurology,The First Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市第一医院神经内科五病区

出　　处：《河北医药》2019年第16期2480-2482,2486,共4页Hebei Medical Journal

摘　　要：目的观察阿托伐他汀强化治疗对急性脑梗死(acute cerebral infarction,ACI)的近期临床疗效影响及CISS分型的关系。方法将126例ACI住院患者,随机分为对照组和强化组。其中,强化组68例,入院后即刻给予阿托伐他汀钙40mg,口服14d,此后按20mg/d继续服用90d,同时给予缺血性卒中的基础治疗;对照组58例,入院后即刻给予阿托伐他汀20mg/d,口服90d,同时给予相同缺血性卒中的基础用药。按中国缺血卒中分型(Chinese ischemic stroke subclassification,CISS)病因和发病机制分型,观察分析2组患者治疗前、治疗后14d、90d NIHSS评分及评价治疗后14d、90d疗效;2组治疗前、治疗后14 d、90 d按CISS分型亚组间NIHSS评分比较及不良反应发生情况。结果2组患者治疗14d、90d后强化组疗效均较对照组更显著,且治疗后90d疗效较治疗后14 d疗效更显著(P<0.05)。CISS分型中,除心源性卒中和不明原因卒中外,强化组中其他3种病因患者的NIHSS评分减少程度均优于对照组的相同类型(P<0.05)。2组在治疗过程中均未发现严重不良反应。结论阿托伐他汀能安全有效改善ACI患者的神经功能缺失。对ACI患者进行阿托伐他汀强化治疗,可取得更加显著的疗效,在不同CISS分型患者中,阿托伐他汀强化治疗对LAA型、PAD型、OE型患者的疗效和近期预后更显著,而CS型、UE型患者的疗效和近期预后较对照组无显著差异。Objective To observe the effects of intensive atorvastatin treatment on acute cerebral infarction(ACI)and its relationship with Chinese ischemic stroke subclassification(CISS).Methods A total of 126 hospitalized patients with ACI were randomly divided into control group and intensive treatment group.Among them,68 patients in the intensive treatment group were given atorvastatin calcium 40mg orally(1~14d)immediately after admission,followed by 90mg/d orally for 90d,and,in the meantime,basic treatment for ischemic stroke;58 patients in the control group were given atorvastatin 20mg/d orally for 90d,and in the meantime,the same basic medication for ischemic stroke.According to the etiology and pathogenesis of CISS,the NIHSS scores of the two groups before treatment,at 14d and 90d after treatment,and the efficacy at 14d and 90d after treatment were evaluated.The NIHSS scores of the CISS and incidence of adverse reactions were compared before treatment,at 14d and 90d after treatment.Results The therapeutic effects in intensive treatment group were more significant than those in control group at 14d and 90 d after treatment,and the therapeutic effects at 90d after treatment were more significant than those at 14d after treatment(P<0.05).In terms of the CI the efficacy was more significant at 90d after treatment than that at 14d after treatment(P<0.05).In terms of the CISS,except for cardiogenic stroke and unexplained stroke,the NIHSS scores in intensive treatment group were significantly lower than those in control group(P<0.05).No serious adverse reactions were found in both groups during the treatment.Conclusion Atorvastatin is safe and effective in improving neurological deficits in patients with ACI,and intensive treatment with atorvastatin in patients with ACI can achieve more significant effects.In different CISS patients,the efficacy and short-term prognosis of intensive atorvastatin treatment for LAA,PAD,and OE patients is more significant,while those for CS and UE patients are not significantly different from

关 键 词：急性脑梗死 强化他汀 疗效 中国缺血卒中分型(CISS分型) 

分 类 号：R743.33[医药卫生—神经病学与精神病学]