急性缺血性脑血管病患者应用他汀药物降脂强度疾病风险与疗效观察研究  

Lipid-lowering efficacy and safety of different doses of atorvastatin for acute cerebral infarction guided by genetic polymorphism detection

作　　者：范玉兰[1] 王勇[1] FAN Yu-lan;WANG Yong(Department of Neurology,Jilin People’s Hospital,Jilin 132001,China)

机构地区：[1]吉林市人民医院神经内科,132001

出　　处：《中国实用医药》2020年第18期1-3,共3页China Practical Medicine

基　　金：吉林市医疗卫生指导性计划项目(项目编号:201830455)。

摘　　要：目的分析在基因多态性检测指导下不同剂量阿托伐他汀对急性脑梗死患者的降脂疗效及安全性。方法 200例急性脑梗死患者,随机分为a组(67例)、 b组(67例)和c组(66例),分别给予阿托伐他汀40、20、10 mg治疗。观察三组治疗1、3、5个月时的肝功能转氨酶、肌酸激酶、肌酸激酶同工酶水平及低密度脂蛋白胆固醇(LDL-C)达标情况。结果 a组治疗3个月时,发现1例肌酸激酶伴有转氨酶升高,其他均正常。治疗1个月时, a组LDL-C达标率89.6%高于b组的56.7%与c组的22.7%,差异有统计学意义(χ^2=18.383、60.375, P<0.05);b组LDL-C达标率高于c组,差异有统计学意义(χ^2=16.025, P<0.05)。三组LDL-C达标率:c组<b组<a组。治疗3个月时, a组LDL-C达标率98.5%与b组的92.5%比较,差异无统计学意义(χ^2=2.792, P>0.05);c组LDL-C达标率60.6%均低于a组与b组,差异有统计学意义(χ^2=29.520、18.964, P<0.05)。三组LDL-C达标率:c组<b组<a组。治疗5个月时,三组LDL-C全部达标,比较差异无统计学意义(P>0.05)。结论在基因多态性检测指导下,脑梗死急性期大剂量强化降脂治疗的推荐剂量为40 mg/d, 1个月后调整为20 mg/d,监测下坚持服用,既有效又安全、经济。Objective To analyze the lipid-lowering efficacy and safety of different doses of atorvastatin for acute cerebral infarction guided by genetic polymorphism detection. Methods A total of 200 acute cerebral infarction patients were randomly divided into group a(67 cases), group b(67 cases) and group c(66 cases), and were treated with atorvastatin 40, 20, and 10 mg, respectively. The liver function transaminase, creatine kinase, creatine kinase isoenzyme levels and low-density lipoprotein cholesterol(LDL-C) standard-reaching status were observed after 1, 3, and 5 months of treatment among three groups. Results In group a, 1 case of creatine kinase and aminotransferase elevation was found after 3 months of treatment, and the others were normal. After 1 month of treatment, the standard-reaching rate of LDL-C 89.6% of group a was higher than that of group b 56.7% and group c 22.7%, and the difference was statistically significant(χ^2=18.383, 60.375, P<0.05). The standardreaching rate of LDL-C of group b was higher than that of group c, and the difference was statistically significant(χ^2=16.025, P<0.05). The standard-reaching rate of LDL-C of three groups were group c < group b < group a. After 3 months of treatment, the standard-reaching rate of LDL-C 98.5% of group a had no statistically significant difference compared with that of group b 92.5%(χ^2=2.792, P>0.05). The standard-reaching rate of LDL-C 60.6% of group c was lower than that of group a and group b, and the difference was statistically significant(χ^2=29.520, 18.964, P<0.05). The standard-reaching rate of LDL-C of three groups were group c < group b< group a. After 5 months of treatment, all three groups reached the standard, and the difference was not statistically significant(P>0.05). Conclusion Under the guidance of genetic polymorphism detection, the recommended dose of high-dose intensive lipid-lowering therapy in the acute phase of cerebral infarction is 40 mg/d, then adjust to 20 mg/d after 1 month. It is effective, safe, and consistent administ

关 键 词：急性脑梗死 SLCOIBI基因 载脂蛋白E基因 阿托伐他汀钙 

分 类 号：R743.3[医药卫生—神经病学与精神病学]