瑞舒伐他汀联合阿托伐他汀治疗急性脑梗死合并高脂血症患者的临床研究  

Clinical trial of rosuvastatin combined with atorvastatin in the treatment of patients with acute ischemic stroke and hyperlipidemia

作　　者：凡奇[1] 马龙[1] FAN Qi;MA Long(Department of Neurology,Bozhou People's Hospital,Bozhou 236800,Anhui Province,China)

机构地区：[1]亳州市人民医院神经内科,安徽亳州236800

出　　处：《中国临床药理学杂志》2024年第18期2611-2615,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的探究瑞舒伐他汀联合阿托伐他汀对急性脑梗死(AIS)合并高脂血症患者脂代谢、脑血流动力学和神经功能的影响。方法将AIS合并高脂血症患者分为试验组和对照组。试验组在基础治疗的基础上睡前给予口服瑞舒伐他汀钙片20mg治疗,qd;对照组在基础治疗的基础上睡前给予口服阿托伐他汀片60mg,qd,疗程均为10d。比较2组患者临床疗效、治疗前后神经功能指标[美国国立卫生研究院脑卒中量表(NIHSS)、改良Rankin量表(mRS)]、脂代谢指标[总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)]、脑血流动力学指标[大脑中动脉收缩期峰值流速(Vs)、平均血流速度(Vm)和波动指数(PI)]、颈动脉斑块相关指标[膜中层厚度(IMT)及低回声斑块]变化,并进行安全性评价。结果试验组和对照组分别纳入47和45例。治疗后,试验组和对照组的治疗总有效率分别为95.74%和86.67%,在统计学上差异无统计意义(P>0.05)。治疗后,试验组和对照组的NIHSS评分分别为(5.59±1.03)和(7.21±1.38)分,mRS评分分别为(1.95±0.24)和(2.38±0.26)分,TC水平分别为(2.79±0.41)和(3.28±0.45)mmol·L^(-1),LDL水平分别为(2.57±0.43)和(2.92±0.40)mmol·L^(-1),Vs分别为(80.67±3.71)和(76.28±5.13)cm·s^(-1),Vm分别为(47.52±4.16)和(44.07±4.86)cm·s^(-1),PI分别为0.85±0.13和1.04±0.19,IMT值分别为(1.58±0.21)和(1.76±0.19)mm,低回声斑块比例分别为17.02%和35.56%,试验组的上述指标与对照组比较,在统计学上差异均有统计学意义(均P<0.05)。试验组的药物不良反应主要有胃肠道反应、头痛头晕、肌肉痛,对照组的药物不良反应主要有胃肠道反应、头痛头晕、疲劳。试验组、对照组的总药物不良反应发生率分别为6.38%和8.89%,在统计学上差异无统计学意义(P>0.05)。结论瑞舒伐他汀及阿托伐他汀对AIS并高脂血症均具有较好的治疗效果,但瑞舒伐他汀改善脂代谢、脑血流动力学及促进患�Objective To explore the influence of rosuvastatin combined with atorvastatin on lipid metabolism,cerebral hemodynamics and neurological function in patients with acute ischemic stroke(AIS)complicated with hyperlipidemia.Methods Patients in the treatment group were oral administered with rosuvastatin calcium tablets 20 mg at bedtime on the basis of basic treatment,qd;patients in the control group were oral administered with atorvastatin tablets 60 mg before going to bed on the basis of basic treatment,qd,for 10 d.The clinical efficacy of the two groups was compared.The changes and safety of neurological function indexes[National Institutes of Health Stroke Scale(NIHSS),modified Rankin Scale(mRS)],lipid metabolism indexes[total cholesterol(TC),low density lipoprotein(LDL),high density lipoprotein(HDL)],cerebral hemodynamics indexes[peak systolic velocity(Vs),mean velocity(Vm)and pulsatility index(PI)of middle cerebral artery]and carotid plaque related indexes[intima-media thickness(IMT)and proportion of low echo plaque] before and after treatment were observed.And the safety evaluation is carried out.Results Finally,47 cases and 45 cases were included in the treatment group and the control group,respectively.After treatment,the total effective rate of the treatment group and the control group was 95.74%and 86.67%,respectively,with no statistical significance(P>0.05).After treatment,the NIHSS scores of treatment group and control group were(5.59±1.03)and(7.21±1.38)points,respectively;mRS scores were(1.95±0.24)and(2.38±0.26)points,respectively;TC levels were(2.79±0.41)and(3.28±0.45)mmol·L^(-1),respectively;LDL levels were(2.57±0.43)and(2.92±0.40)mmol.L^(-1),respectively;Vs levels were(80.67±3.71)and(76.28±5.13)cm·s^(-l);Vm levels were(47.52±4.16)and(44.07±4.86)cm·s^(-1),respectively;PI were 0.85±0.13 and 1.04±0.19;IMT were(1.58±0.21)and(1.76±0.19)mm,respectively;the proportion of hypoechoic plaque were 17.02%and 35.56%,respectively.There were statistically significant differences between the above

关 键 词：瑞舒伐他汀钙片 阿托伐他汀片 急性脑梗死 高脂血症 脂代谢 脑血流动力学 神经功能 

分 类 号：R972[医药卫生—药品]