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目的:探讨他汀类药物对脑梗死患者预后的影响。方法:采用随机、双盲、安慰剂对照的方法进行研究,将2004-02/07大连医科大学附属第一医院收治的46例脑梗死患者分为对照组及他汀组(辛伐他汀40mg/d或阿托伐他汀20mg/d,连续用药7d)。治疗前后检测血清谷草转氨酶(AST)及血清肌酸激酶(CK)水平,应用美国国立卫生研究院卒中量表(NIHSS)及Barthel指数(BI)记分法对入选患者在入院时及3个月时的神经功能缺损程度进行评分。结果:对照组、辛伐他汀组及阿托伐他汀组神经功能缺失程度评分(中位数)入院时(NIHSS1,BI1)为:5.00,75.00;8.00,80.00;6.00,85.00;3个月时(NIHSS2,BI2)为:2.00,100.00;4.00,100.00;1.00,100.00。各组入院时神经功能缺失程度评分与3个月后相比差异均有显著性意义(P<0.01或P<0.05),但不同组之间相比无明显差别。治疗后各组AST及CK水平无明显变化。结论:短期应用他汀类药物安全性好,但对梗死后3个月的预后无明显改善作用。他汀类药物对脑梗死的疗效需要进一步研究。
Objective: To investigate the effect of statins on the prognosis of patients with cerebral infarction. METHODS: A randomized, double-blind, placebo-controlled study was conducted. Forty-six patients with cerebral infarction admitted to the First Affiliated Hospital of Dalian Medical University from February to February 2004 were divided into control group and statin group (simvastatin 40 mg / d Or atorvastatin 20mg / d, continuous medication 7d). Serum aspartate aminotransferase (AST) and serum creatine kinase (CK) levels were measured before and after treatment. NIHSS and Barthel Index (BI) The degree of neurological deficits were scored. Results: At the time of admission (NIHSS1, BI1), the score of neurological deficit in the control group, simvastatin group and atorvastatin group was 5.00, 75.00, 8.00, 80.00, 6.00 and 85.00 respectively. At 3 months (NIHSS2, BI2) is: 2.00, 100.00; 4.00, 100.00; 1.00, 100.00. The score of neurological deficit at admission was significantly different from that at 3 months (P <0.01 or P <0.05), but there was no significant difference between different groups. After treatment, the levels of AST and CK in each group did not change significantly. Conclusion: Short-term statin use is safe but has no significant effect on the prognosis at 3 months after infarction. The efficacy of statins on cerebral infarction needs further study.