不同剂量阿托伐他汀治疗急性缺血性脑卒中继发早期神经功能恶化疗效观察  

Efficacy of Different Doses of Atorvastatin in the Treatment of Early Neurological Deterioration After Acute Ischemic Stroke

作　　者：刘云平[1] 赵洪海[1] 张贺齐 李迥[1] 尚淑玲[1] 于心洋 LIU Yunping;ZHAO Honghai;ZHANG Heqi;LI Jiong;SHANG Shuling;YU Xinyang(Department of Neurology,Tangshan Union Medical College Hospital,Tangshan,Hebei,China 063000)

机构地区：[1]河北省唐山市协和医院神经内科,河北唐山063000

出　　处：《中国药业》2021年第23期79-82,共4页China Pharmaceuticals

基　　金：河北省卫生和计划生育委员会科研基金[20171309]。

摘　　要：目的探讨不同剂量阿托伐他汀治疗急性缺血性脑卒中(AIS)继发早期神经功能恶化(END)的疗效。方法选取医院2017年9月至2019年4月确诊为AIS继发END的患者150例,按随机数字表法分为A组、B组、C组,各50例。3组患者均口服阿托伐他汀钙片治疗,剂量为A组10 mg/d,B组20 mg/d,C组初始40 mg/d、2周后降至20 mg/d,均治疗4周。结果治疗后,3组患者美国国立卫生研究院卒中量表(NIHSS)评分,以及C反应蛋白、总胆固醇、低密度脂蛋白胆固醇、三酰甘油水平均显著降低,且C组显著低于A组和B组,B组显著低于A组(P<0.05);3组患者巴塞尔指数(Barthel)评分均显著升高,且C组显著高于A组和B组,B组显著高于A组(P<0.05);C组患者总有效率为88.00%,显著高于A组和B组的66.00%和78.00%(P<0.05);A组、B组、C组治疗期间不良反应发生相当(14.00%,18.00%,14.00%,P>0.05)。结论高剂量阿托伐他汀治疗AIS继发END,可促进患者的神经功能恢复,显著降低C反应蛋白及血脂水平,提高治疗效果,改善短期预后。Objective To investigate the efficacy of different doses of atorvastatin in the treatment of early neurological deterioration(END)after acute ischemic stroke(AIS).Methods A total of 150 patients with END after AIS diagnosed in the hospital from Septem-ber 2017 to April 2019 were selected and randomly divided into group A,group B and group C,50 cases in each group.All the pa-tients in the three groups were treated with Atorvastatin Calcium Tablets,with a dose of 10 mg/d in group A,20 mg/d in group B,and with an initial dose of 40 mg/d in group C,which decreased to 20 mg/d after two weeks.All the patients were treated for four weeks.Results After treatment,the scores of the National Institutes of Health Stroke Scale(NIHSS)and the levels of C-reactive pro-tein(CRP),total cholesterol(TC),low-density lipoprotein(LDL),cholesterol and triacylglycerol(TG)in the three groups were significantly lower than those before treatment,those in group C were significantly lower than those in group A and group B,and those in group B were significantly lower than those in group A(P<0.05),while the score of Barthel index in the three groups was significantly higher than that before treatment,that in group C was significantly higher than that in group A and group B,and that in group B was significantly higher than that in group A(P<0.05).The total effective rate of group C was 88.00%,which was significantly higher than 66.00%and 78.00%of group A and group B(P<0.05).The incidence of adverse reactions in group A,group B and group C was similar(14.00%,18.00%,14.00%,P>0.05).Conclusion High-dose atorvastatin in the treatment of END after AIS can pro-mote the recovery of neurological function,significantly reduce the levels of CRP and blood lipid,improve the clinical efficacy and the short-term prognosis.

关 键 词：阿托伐他汀 剂量 急性缺血性脑卒中 早期神经功能恶化 短期转归 血清C反应蛋白 血脂 

分 类 号：R969.4[医药卫生—药理学] R972.6[医药卫生—药学]