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目的探讨瑞舒伐他汀对脑梗死合并颈动脉粥样硬化患者血脂、复发率的影响。方法收集2012年6月—2013年8月期间在本院神经内科住院治疗的急性脑梗死伴颈动脉粥样硬化患者162例。随机分为实验组和对照组,每组各81例。对照组采用肠溶阿司匹林治疗,口服,100 mg/次,1次/d,连续治疗6个月。实验组在常规治疗基础上加用瑞舒伐他汀,口服,10 mg/次,1次/晚,治疗6个月。比较两组治疗前后血脂指标、炎症指标、颈动脉内膜-中层厚度(intima-media thickness,IMT)的变化及脑梗死复发情况。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果治疗后,实验组TC、TG、LDL分别为(4.32±0.56)、(1.65±0.23)、(2.52±0.77)mmol/L,均明显低于对照组[(5.84±0.35)、(1.74±0.31)、(4.20±1.23)mmol/L],治疗后,实验组HDL为(1.13±0.27)mmol/L,明显高于对照组的(0.98±0.22)mmol/L,对比差异均有统计学意义(均P<0.05)。实验组在治疗后hs-CRP、IL-6水平分别为(2.43±0.92)mg/L、(49.72±12.47)pg/ml,均低于对照组[(2.95±1.25)mg/L、(55.92±12.15)pg/ml],对比差异均有统计学意义(均P<0.05)。治疗后实验组的IMT为(1.22±0.11)mm,明显低于对照组的(1.47±0.13)mm,对比差异有统计学意义(P<0.05)。结论瑞舒伐他汀可明显降低脑梗死合并颈动脉粥样硬化患者的TC、TG、LDL-C水平,增加HDL-C水平,同时可降低颈动脉IMT,降低脑梗死复发风险。
Objective To investigate the effect of rosuvastatin on blood lipids and recurrence in patients with cerebral infarction and carotid atherosclerosis. Methods A total of 162 acute cerebral infarction patients with carotid atherosclerosis hospitalized in our department of neurology from June 2012 to August 2013 were collected. Randomly divided into experimental group and control group, each group of 81 cases. Control group was treated with enteric-coated aspirin, orally, 100 mg / time, 1 time / d, continuous treatment for 6 months. The experimental group was given rosuvastatin on the basis of routine treatment, orally, 10 mg / time, once / night for 6 months. Serum lipids, inflammation, carotid artery intima-media thickness (IMT) and recurrence of cerebral infarction were compared between the two groups before and after treatment. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results After treatment, the levels of TC, TG and LDL in experimental group were significantly lower than those in control group [(4.32 ± 0.56), (1.65 ± 0.23) and (2.52 ± 0.77) mmol / L, respectively] 0.31), (4.20 ± 1.23) mmol / L]. After treatment, the HDL in the experimental group was (1.13 ± 0.27) mmol / L, which was significantly higher than that in the control group (0.98 ± 0.22) mmol / L Significance (all P <0.05). The levels of hs-CRP and IL-6 in the experimental group were (2.43 ± 0.92) mg / L and (49.72 ± 12.47) pg / ml, ± 12.15) pg / ml], the differences were statistically significant (P <0.05). After treatment, the IMT of the experimental group was (1.22 ± 0.11) mm, which was significantly lower than that of the control group (1.47 ± 0.13) mm, the difference was statistically significant (P <0.05). Conclusion Rosuvastatin can significantly reduce the level of TC, TG and LDL-C in patients with cerebral infarction and carotid atherosclerosis, increase the level of HDL-C, reduce the carotid IMT and reduce the risk of recurrent cerebral infarction.