不同剂量阿托伐他汀治疗对急性脑梗死患者纤维蛋白原的影响

目的 探讨急性脑梗死患者使用两种剂量阿托伐他汀(10 mg和20 ms)治疗3 d后血浆纤维蛋白原(Fg)水平的变化.方法 对确诊为急性脑梗死的102例患者随机分为常规治疗组(33例,不接受任何调脂药物治疗)、10 mg阿托伐他汀治疗组(30例,10 mg阿托伐他汀治疗3 d)和20 mg阿托伐他汀治疗组(39例,20 mg阿托伐他汀治疗3 d).并测定各组治疗前后Fg和血脂水平的变化.结果 治疗3 d后,10 mg阿托伐他汀治疗组血浆Fg水平与常规治疗组比较差异无统计学意义,而20 mg阿托伐他汀治疗组Fg水平明显低于常规治疗组,20 mg阿托伐他汀治疗组Fg水平下降幅度与常规治疗组比较差异有统计学意义(21.6%比3.2%,P<0.05).三组治疗前后血脂各项指标变化差异均无统计学意义.20mg阿托伐他汀治疗引起的血浆Fg水平下降与总胆固醇r=0.125,P=0.618)、三酰甘油(r=0.147,P=0.573)、低密度脂蛋白胆同醇(r=-0.279,P:0.235)、高密度脂蛋白胆固醇r=-0.021,P=0.157)的下降百分数之间无相关性.结论 急性脑梗死患者大剂量阿托伐他汀(20 mg)治疗3 d后,可明显降低Fg水平及改善内皮功能,有利于动脉粥样硬化斑块的稳定.

Effects of atorvastatin in different dosage on plasma level of fibrinogen in patients with acute cerebral infarction

Objective To investigate whether intervention with two different dosage of atorvastatin may benefit to plasma level of fibrinogen (Fg) in patients with acute cerebral infarction. Methods One hundred and two patients with acute cerebral infarction were randomly assigned into three groups:the control group (33 cases) treated without lipid-lowering drugs, 10 rag (30 cases) and 20 mg (39 cases) atorvastatin group with 3 days of treatment. Before and after the treatment, the plasma levels of Fg and lipids were detected.Results The treatment of 10 mg atorvastatin did not significantly decrease the level of Fg. Compared to the control group, the level of Fg was markedly reduced by 20 mg atorvastatin (21.6% vs 3.2%,P< 0.05). No changes of lipid levels were observed in any group before and after the treatment, whilst there was no relation between the decreasing percentage of Fg and that of TC(r = 0.125 ,P= 0.618), TG(r = 0.147,P = 0.573) or LDL- C (r = -0.279, P = 0.235 ), HDL-C (r = -0.021, P = 0.157). Conclusion Treatment with high dose atorvastatin (20 mg) for 3 days could reduce the level of Fg, and improve the function of vascular endothehum,which may promote the stabilization of atherosclerotic plaque.