阿托伐他汀治疗急性缺血性脑卒中的量效关系探讨

目的探讨不同剂量阿托伐他汀治疗急性缺血性脑卒中的临床疗效。方法将125例急性缺血性脑卒中患者随机分为3组,阿托伐他汀剂量为A组10 mg/d,B组20 mg/d,C组不加用任何调脂药物。比较治疗前后3组患者血脂、炎性因子和纤维蛋白原(FIB)水平,以及神经功能缺损情况和日常生活能力的变化。结果 B组TC、TG、LDL-C下降幅度显著大于A组(P0.05);A、B组炎性因子水平下降幅度及ADL及NIHSS评分改善幅均显著大于C组(P0.01),且B组炎性因子和FIB水平下降幅度显著大于A组(P0.05)。结论与10 mg/d的剂量相比,20 mg/d的阿托伐他汀治疗急性缺血性脑卒中患者,可更为有效地降脂、抗炎,从而稳定动脉粥样硬化斑块,恢复神经系统损伤,提高生活质量,且安全性较好。

Study on dose-effect relationship in atorvastatin therapy for acute ischemic stroke

Objective To investigate the clinical effect of different doses of atorvastatin in the treatment of acute ischemic stroke.Methods One hundred and twenty-five cases of acute ischemic stroke were divided into three groups randomly. Group A received atorvastatin 10 mg/d, group B received atorvastatin 20 mg/d, and group C did not receive any lipid-lowering drugs. The blood levels of lipids, inflammatory cytokines, and fibrinogen (FIB), neurological impairment status, and viability before and after treatment were evaluated among the three groups.Results The decreases in levels of total cholesterol, triglyceride, and low-density lipoprotein cholesterol in group B were significantly higher than those in group A (P<0.05). The decreases in levels of inflammatory cytokines and increases in scores of Activities of Daily Living and National Institute of Health Stroke Scale in groups A and B were significantly higher than those in group C (P<0.01). The decreases in levels of inflammatory cytokines and FIB in group B were significantly higher than those in group A (P<0.05).Conclusions For patients with acute ischemic stroke, atorvastatin 20 mg/d, compared with atorvastatin 10 mg/d, can lower lipid levels and reduce inflammation more effectively, so as to stabilize atherosclerotic plaques, restore the nervous system function, and improve the quality of life with higher safety.