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目的探讨阿托伐他汀对糖尿病并短暂性脑缺血发作(TIA)患者血脂、高敏C-反应蛋白(hs-CRP)的影响及其临床意义。方法选择糖尿病并TIA患者160例随机分为治疗组80例和对照组80例,对照组常规饮食控制、降糖药物、肠溶阿司匹林75 mg 1次/d口服1 a,低分子肝素纳5 000 U 1次/d皮下注射1周。治疗组在对照组治疗基础上给予阿托伐他汀20 mg每晚顿服1 a。两组均于入院24 h内及治疗后4周测定血脂及hs-CRP值,分析1 a脑卒中事件的发生率。结果治疗组hs-CRP、TC、LDL-C明显低于治疗前(P<0.05),HDL-C高于治疗前变化均有统计学意义(P<0.05)。TG治疗前后差异无统计学意义(P>0.05)。对照组治疗前后各指标差异无统计意义(P>0.05),治疗组1 a内脑卒中事件发生率显著低于对照组(P<0.01)。结论:阿托伐他汀的调脂及减轻炎症反应作用确定,可改善血管内及功能,预防动脉硬化进展,对糖尿病并TIA的发生、发展及预后有重要作用。
Objective To investigate the effect of atorvastatin on blood lipids and high-sensitivity C-reactive protein (hs-CRP) in patients with diabetes and transient ischemic attack (TIA) and its clinical significance. Methods One hundred and sixty patients with diabetes and TIA were randomly divided into treatment group (n = 80) and control group (n = 80). The control group was given conventional diet control, hypoglycemic agents, 75 mg once daily for oral aspirin for 1 year and low molecular weight heparin 5 000 U 1 times / d subcutaneous injection for 1 week. The treatment group was given atorvastatin 20 mg per night for 1 year on the basis of the control group. Blood lipid and hs-CRP were measured within 24 hours after admission and 4 weeks after treatment in both groups, and the incidence of stroke at 1 year was analyzed. Results The hs-CRP, TC and LDL-C in the treatment group were significantly lower than those before treatment (P <0.05), and the HDL-C levels were higher than those before treatment (P <0.05). TG difference was not statistically significant (P> 0.05). There was no significant difference in each index before and after treatment in the control group (P> 0.05). The incidence of stroke in the treatment group within 1 year was significantly lower than that in the control group (P <0.01). Conclusion: Atorvastatin can decrease the inflammatory reaction and the function of lipid-lowering and atherosclerosis. It can improve the function of blood vessels and prevent the progression of atherosclerosis. It plays an important role in the occurrence, development and prognosis of TIA in diabetes mellitus.