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目的:探讨他汀治疗在低密度脂蛋白胆固醇(LDL-c)偏低的动脉粥样硬化性脑梗死(ACI)患者中二级预防的疗效。方法:入选103例LDL-c小于2.1mmol/L的ACI患者,随机分为常规治疗组(51例)和他汀治疗组(52例),分析比较组间和组内阿托伐他汀治疗1月后LDL-c水平的变化,同时观察患者急性期(1月)内和1年随访期间脑血管事件及神经功能缺损情况。结果:治疗1月后,他汀治疗组的LDL-c水平和治疗前比较下降无显著性差异(P>0.05),但与常规治疗组相比,急性期内患者神经功能缺损评分降低,差异有统计学意义(P<0.05)。随访1年期间缺血性脑卒中的复发率较常规对照组降低,神经功能缺损的加重也显著低于常规治疗组(P<0.05)。结论:LDL-c偏低的ACI患者因早期启动他汀治疗而受益,其原因可能并不是单一依赖降脂这一途径,而是通过其他神经保护功能起到作用。
Objective: To investigate the efficacy of statin therapy in secondary prevention of low-density lipoprotein cholesterol (LDL-c) in patients with atherosclerotic cerebral infarction (ACI). Methods: A total of 103 ACI patients with LDL-c less than 2.1 mmol / L were enrolled and randomly divided into routine treatment group (n = 51) and statin treatment group (n = 52) After the change of LDL-c levels, while observing the patients during acute phase (January) and 1-year follow-up of cerebrovascular events and neurological deficits. Results: After 1 month of treatment, the LDL-c level in statin group was not significantly different from that before treatment (P> 0.05), but the score of neurological deficit in acute phase was lower than that of routine treatment group Statistical significance (P <0.05). The recurrence rate of ischemic stroke during one year follow-up was lower than that of the control group and the severity of neurological deficit was also significantly lower than that of the conventional treatment group (P <0.05). CONCLUSIONS: ACI patients with low LDL-c benefit from early initiation of statin therapy and may not be solely dependent on lipid-lowering mechanisms, but rather through other neuroprotective functions.