瑞舒伐他汀强化降脂对缺血性脑卒中血脂及颈动脉粥样硬化斑块的影响

目的 探讨瑞舒伐他汀强化降脂对缺血性脑卒中血脂及颈动脉粥样硬化斑块的影响.方法 72例缺血性脑卒中患者随机分为强化降脂组和普通降脂组.2组患者均予以控制颅压、血压和血糖、抗血小板聚集、改善脑循环等基础治疗.普通降脂组加用瑞舒伐他汀片10 mg,/次,1次/d；强化降脂组加用瑞舒伐他汀片20mg/次,1次/d,连用6个月.观察并比较2组患者治疗前后血脂水平及颈动脉粥样硬化斑块的变化.结果 治疗6个月后,2组患者总胆固醇（TC）、甘油三酯（TG）和低密度脂蛋白胆固醇（LDL-C）水平均较治疗前明显下降,高密度脂蛋白（HDL-C）均较治疗前明显上升（P＜0.05或P＜0.01）,且强化降脂组下降或上升较普通降脂组幅度更大（P＜0.05）；同时2组患者的斑块大小、厚度和内-中膜厚度（IMT）均较治疗前明显下降（P＜0.05或P＜0.01）,且强化降脂组下降较普通降脂组幅度更大（P＜0.05）.结论 瑞舒伐他汀强化降脂治疗缺血性脑卒中具有较好的疗效和良好的调脂作用,可降低颈动脉斑块的大小、厚度和IMT,延缓和逆转颈动脉粥样硬化斑块的进展.

Effects of rosuvastatin intensive lipid-lowering on blood fat in patients with cerebral arterial thrombosis and formation of carotid atherosclerotic plaque

Objective To investigate the effects of rosuvastatin intensive lipid-lowering on blood fat in patients with cerebral arterial thrombosis and formation of carotid atherosclerotic plaque.Methods Seventy-two patients with ischemic stroke were,on the basis of intracranial pressure,blood pressure and blood sugar control,anti-platelet aggregation and improvement of cerebral circulation,randomly allocated to be treated with rosuvastatin 10 mg once daily （common lipid-lowering group） or rosuvastatin 20 mg once daily for 6 months （intensive lipid-lowering group）,respectively.This entailed comparison on the changes in lipid levels and formation of carotid atherosclerosis plaque before and after treatment.Results Treatment with rosuvastatin for 6 months resulted in markedly reduced levels of total cholesterol （TC）,total glycerol （TG） and low-density lipoprotein cholesterol （LDL-C） yet increased level of high-density lipoprotein cholesterol （HDL-C） （all P＜0.05）,particularly in intensive lipid-lowering group （P＜0.05）.There was a considerable reduction in the size,thickness and intimal-media wall thickness （IMT） of the arterial plaque （all P＜0.05）,particularly in intensive lipid-lowering group （P＜0.05）.Conclusion Rosuvastatin for intensive lipid-lowering therapy achieves a preferable efficacy and modulation of cerebral arterial thrombosis via reduction in the size,thickness and IMT,thus retarding or even reversing the development of carotid atherosclerotic plaque.