目的 观察非小卒中患者急性期强化他汀治疗的疗效及安全性。方法 选取发病24 h内非小卒中患者125例,按随机数字表法分为阿托伐他汀强化组(62例)和常规组(63例)。强化组及常规组从入院起分别予阿托伐他汀40 mg、20 mg,每晚一次口服,监测治疗前、发病2周总胆固醇(Tch)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、肝功能、肌酸激酶,并记录治疗前后美国国立卫生院卒中量表(NIHSS评分)、治疗后改良Rankin量表(mRS)、治疗后症状性脑梗死后出血转化事件,以及发病3个月脑梗死复发情况。结果 经治疗两组患者NIHSS评分较治疗前下降,强化组患者NIHSS评分下降更为明显(P<0.05)。强化组患者发病2周时mRS评分低于常规组(P<0.05)。发病3个月后两组均有脑梗死复发患者,两组间差异无统计学意义。2周后复测血脂,经治疗两组患者Tch、TG、LDL-C均较治疗前下降,且强化组的Tch、TG、LDL-C水平均低于常规组(P<0.05)。治疗后两组均有肝功异常、CK异常及症状性出血转化的病例,其发生率两组间差异无统计学意义。结论 非小卒中患者急性期强化他汀治疗可改善血脂水平、促进神经功能恢复,且无明显不良反应发生。
Abstract
Objective To observe the effectiveness and safety of high dose atorvastatin in the treatment of acute ischemic non-minor stroke.Methods A total of 125 patients within 24 hours of acute ischemic stroke onset whose NIHSS scores were less than 4 were randomly divided into the high dose group(62 patients) and the conventional dose group(63 patients).The high dose group and the conventional dose group received atorvastatin 40 mg and atorvastatin 20 mg before bedtime respectively.TCH, TG, HDL-C, LDL-C, liver test, creatine kinase, NIHSS score, mRS, and the number of symptomatic intracranial hemorrhage patients were observed in both groups before and after two weeks of treatment, while the rate of cerebral infarction recurrence was observed after three months of treatment.Results After treatment, NIHSS scores of the two groups were decreased, especially in the high dose group, so there was significant difference (P<0.05).mRS of the two groups was also decreased, especially in the high dose group, and the difference was significant(P<0.05).There was no significant difference in the incidence of cerebral infarction between the two groups.TCH, TG and LDL-C of the two groups were decreased after two weeks of treatment, especially so in the high dose group, so there was significant difference (P<0.05).Between the two groups, there was no significant difference in the rate of liver test abnormalities, creatine kinase abnormalities or symptomatic intracranial hemorrhage.Conclusions A high dose of atorvastatin therapy for acute ischemic non-minor stroke can improve blood lipid levels and neurological function, and no obvious adverse reactions occur.
关键词
阿托伐他汀 /
急性脑梗死 /
非小卒中 /
疗效 /
症状性出血转化
Key words
atorvastatin /
acute cerebral infarction /
non-minor stroke /
therapeutic efficacy /
symptomatic intracranial hemorrhage
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