不同剂量阿托伐他汀对脑梗死患者疗效、血脂及颈动脉内膜的影响

目的 观察不同剂量阿托伐他汀对脑梗死患者神经功能缺损及血脂、颈动脉内—中膜厚度（IMT）的影响.方法 血脂水平在正常范围首次发生脑梗死患者80例,随机分为治疗组（40例）和对照组（40例）,治疗组在常规治疗基础上给予阿托伐他汀钙每次40 mg,1天1次,口服,疗程6个月,对照组常规治疗基础上给予阿托伐他汀钙每次20 mg,1天1次,口服,疗程6个月.分别于治疗后1个月、3个月、6个月进行神经功能缺损评分和巴塞尔评分,治疗后3个月、6个月清晨空腹抽血检测血脂水平,治疗后6个月彩色超声诊断仪检测局部动脉粥样硬化区域内—中膜厚度及斑块情况.结果 治疗组治疗3个月时总胆固醇、低密度脂蛋白、甘油三脂水平、6个月时颈动脉内—中膜厚度、神经功能缺损评分较对照组明显降低,差异有统计学意义（P＜0.05）,而高密度脂蛋白水平及巴塞尔评分则较对照组显著升高,差异有统计学意义（P＜0.05）.结论 大剂量的阿托伐他汀有明确的脑保护作用,更有助于脑梗死后神经功能的恢复,可以提高动脉粥样硬化斑块稳定性,调脂、抗动脉粥样硬化作用明显.

Effects of different doses of atorvastatin on efficacy,blood lipid,and carotid intima in patients with cerebral infarction

Abstract： Objective To observe the effects of different doses of atorvastatin on neurologic impairment, blood lipid, carotid intima- media thickness in acute cerebral infarction patients. Methods Totally 80 acute cerebral infarction patients with normal cholesterol were randomly divided into atorvastatin group （ n = 40） and control group （ n = 40）. Atorvastatin group received 40 mg atorvastatin per day and control group received 20 mg atorvastatin per day based on normal treatment for 6 months. Serum concentration of cholesterol was measured after treatment for 3 and6 months, intima-media thickness and plaques was measured at 6 months,the scores of neural function defect and modified Barthel index were measured 1 month after admission and at 3 and 6 months. Results The serum concentrations of TC, LDL-C ,TG after 3-month treatment and the scores of neural function defect decreased significantly in atorvastatin group after 6-months treatment. Carotid intima-media thickness（IMT） decreased significantly in atorvastatin group after 6-month treatment. There were statistic differences between two groups （ P 〈 0.05 ）. The serum concentration of HDL-C, the scores of Barthel index increased signifi- cantly,with statistic differences between the two groups（P 〈 0.05 ）. Conclusions High dose atorvastatin has protective effects on patients with acute cerebral infarction. It has positive effects on the recovery of nervous system after cerebral infarction, increases stabilization of atherosclerotic plaques. Beneficial effects on normalising blood lipid level and anti-atherosclerotic function is also observed.