不同剂量瑞舒伐他汀对穿支动脉粥样硬化相关卒中患者sdLDL-C水平及复发的影响  

Effect of different doses of rosuvastatin on small dense low-density lipoprotein cholesterol level and recurrence in patients with branch atheromatous stroke

作　　者：杨风刚 张娜[2] 张振岭 时兴华 YANG Feng-gang;ZHANG Na;ZHANG Zhen-ling;SHI Xing-hua(不详;Department of Neurology,Qilu Hospital of Shandong University Dezhou Hospital,Dezhou People's Hospital,Dezhou,Shandong 253000,China)

机构地区：[1]山东大学齐鲁医院德州医院德州市人民医院神经内科,山东德州253000 [2]青岛大学附属医院健康管理中心,山东青岛266000

出　　处：《中国临床研究》2022年第8期1046-1050,共5页Chinese Journal of Clinical Research

基　　金：山东省医药卫生科技发展计划项目(2017WS818)。

摘　　要：目的 探讨不同剂量瑞舒伐他汀对穿支动脉粥样硬化相关卒中患者小而密低密度脂蛋白胆固醇(sdLDL-C)水平及2年内卒中复发的影响。方法 选取2017年1月至2018年12月于德州市人民医院神经内科住院的穿支动脉粥样硬化相关卒中患者246例,随机分成瑞舒伐他汀常规剂量组(10 mg)和强化剂量组(20 mg),于治疗后3、6、12、18、24个月检测sdLDL-C水平并统计卒中复发情况,绘制ROC曲线计算sdLDL-C水平预测穿支动脉粥样硬化相关卒中复发的诊断价值。结果 强化剂量组在治疗后12、18、24个月的sdLDL-C水平和2年内脑卒中复发率显著低于常规剂量组(P<0.05)。治疗后24个月时sdLDL-C水平对穿支动脉粥样硬化相关卒中复发的预测价值较高,AUC为0.865(95%CI:0.795~0.930)。Kaplan-Meier生存分析显示,低sdLDL-C患者2年复发率显著低于高sdLDL-C患者(P<0.05)。结论 强化剂量瑞舒伐他汀(20 mg)可以显著降低穿支动脉硬化卒中患者sdLDL-C水平及2年内胆固醇复发率。sdLDL-C水平对于2年内卒中复发具有重要的提示价值。Objective To explore the impacts of different dose rosuvastatin on the small dense low-density lipoprotein cholesterol(sdLDL-C) level and stroke recurrence within 2 years in patients with branch atheromatous stroke. Methods A total of 246 patients with branch atheromatous stroke hospitalized in Dezhou People’s Hospital from January 2017 to December 2018 were randomly divided into routine-dose(10 mg) group and intensive-dose(20 mg) group according to the dosage of rosuvastatin used. The sdLDL-C levels were detected at 3-, 6-, 12-, 18-and 24-month after treatment, and the recurrence of branch atheromatous stroke was observed. By drawing ROC curve, the diagnostic accuracy of sdLDL-C in predicting the recurrence of branch atheromatous stroke was evaluated. Results The levels of sdLDL-C at 12-, 18-and 24-month after treatment and the recurrence rates of stroke within two years in intensive-dose group were significantly lower than those in routine-dose group(P<0.05). At 24 months after treatment, the level of sdLDL-C had a high predictive value for the recurrence of branch atherosclerosis stroke, with AUC of 0.865(95%CI: 0.795-0.930). Kaplan-Meier survival analysis showed that the 2-year recurrence rate of patients with low sdLDL-C level was significantly lower than that in patients with high sdLDL-C level(P<0.05). Conclusions High-dose rosuvastatin(20 mg) therapy can significantly reduce the sdLDL-C level and the stroke recurrence rate within 2 years in patients with branch atheromatous stroke. The sdLDL-C level has an important predictive value for stroke recurrence within 2 years.

关 键 词：小而密低密度脂蛋白胆固醇 穿支动脉硬化相关卒中 瑞舒伐他汀 复发 

分 类 号：R743.3[医药卫生—神经病学与精神病学]