他汀类药物对脑梗死患者急性期血脂和高敏C反应蛋白的影响

目的观察阿托伐他汀对脑梗死患者急性期的临床疗效、血脂、高敏C反应蛋白(hs-CRP)和纤维蛋白原的影响。方法选择急性脑梗死患者161例,随机分为阿托伐他汀组(A组)58例、洛伐他汀组(B组)59例和对照组44例。对照组常规治疗,A组、B组在常规治疗的基础上分别加服阿托伐他汀、洛伐他汀20mg/d,连续治疗3个月。观察3组治疗前后血脂、hs-CRP、纤维蛋白原及美国国立卫生研究院卒中量表评分等指标的变化。结果治疗1周后,A组、B组TC、LDL-C较对照组明显下降(P<0.01),A组TC、LDL-C较B组下降更明显(P<0.05);3组治疗后hs-CRP均明显下降(P<0.01),A组hs-CRP较B组下降更明显,差异有统计学意义(P<0.05)。结论阿托伐他汀较洛伐他汀能更有效快速调脂,降低hs-CRP水平,短期观察神经缺损评分虽无明显改善,但仍可以考虑在脑梗死早期应用以促进神经功能恢复,且安全性好。

Effect of statins on blood lipid and hs-CRP in patients with acute cerebral infarction

Objective To observe the effect of atorvastatin on blood lipid,high-sensitivity Oreactiveprotein (hs-CRP)and fibrinogen in patients with acute cerebral infarctionC ACI).Methods One hundred and sixty-one ACI patients were randomly divided into group A(n=58),group B(n=59) and control group(n = 44).Patients in group A received routine treatment plus atorvastatin(20 mg/d,for 3 months)and those in group B received routine treatment plus lovastatin(20 mg/d,for 3 months),while those in control group received only routine treatment.Their blood lipid,hs-CRP and fibrinogen levels were measured and NIHSS was observed before and after treatment.Results The TC and LDL-C levels were significantly lower in groups A and B than in control group 7 days after treatment(P<0.01),especially in group A than in group B(P<0.05).The hs-CRP level significantly decreased in 3 groups 7 days after treatment(P<0.01) and was significantly lower in group A than in group B(P<0.05).Conclusion Atorvastatin can regulate blood lipid and reduce hs-CRP level more rapidly and effectively than lovastatin,but cannot significantly improve the neurological deficit score.However,it should be used in treatment of early ACI to promote recovery of nerve function because of its safety.