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目的探讨辛伐他汀在短暂性脑缺血发作(TIA)治疗和二级预防中的应用。方法 2006年1月-2008年12月诊治TIA患者116例随机分为观察组和对照组各58例,对照组根据病情常规应用阿司匹林、尼莫地平、胞二磷胆碱、甘露醇等,同时针对病因治疗,如控制血压、血糖等;观察组在对照组的基础上加辛伐他汀20mg口服,1次/d,长期服用。结果两组近期疗效无明显差异(P>0.05);随访(16.3±7.3)月,与对照组比较观察组发展为脑梗死、合并外周血管栓塞低,TIA复发次数少(P<0.05);两组用药前和用药7d后分别检测血、尿常规,肝、肾功能无明显改变,观察组随访时间出现AST、ALT异常4例,但未超出正常上限的1倍,停药后恢复正常,胃肠胀气4例,均未影响治疗。结论辛伐他汀联合治疗TIA既能在近期控制TIA的发作,又能在二级预防中预防脑梗死、减少外周血管栓塞及TIA复发,且应用安全,可作为治疗TIA的常规用药。
Objective To investigate the application of simvastatin in the treatment and secondary prevention of transient ischemic attack (TIA). Methods From January 2006 to December 2008, 116 patients with TIA were randomly divided into observation group (58 cases) and control group (58 cases). The control group was given aspirin, nimodipine, citicoline and mannitol For the cause of treatment, such as control of blood pressure, blood glucose, etc .; observation group in the control group on the basis of simvastatin 20mg orally, 1 / d, long-term use. Results There was no significant difference between the two groups in the short term efficacy (P> 0.05). Follow-up (16.3 ± 7.3) months, compared with the control group, the observation group developed cerebral infarction with low peripheral embolization and fewer TIA recurrences (P <0.05) The blood and urine routine, liver and kidney function were not significantly changed before treatment and 7 days after treatment. The AST and ALT abnormalities were observed in 4 cases in the observation group at follow-up time, but did not exceed 1 times of the normal upper limit, returned to normal after stopping the medicine, Flatulence in 4 cases, did not affect the treatment. Conclusions Simvastatin combined with TIA can both control the onset of TIA in the near future, prevent cerebral infarction in secondary prevention, decrease peripheral embolism and recurrence of TIA, and can be used as a regular medication for TIA.