阿托伐他汀强化降脂对脑梗死患者血脂及颈动脉内膜中层厚度的影响(1)
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[摘要] 目的观察脑梗死患者强化降脂后，血脂及颈动脉内膜中层厚度(carotid arterial intima-media thickness，CIMT)的变化。方法将60例脑梗死患者随机分为阿托伐他汀强化降脂(20mg/d)组30例，常规剂量(10mg/d)组30例，分别于用药前及用药6个月后测定血脂，超声观察CIMT的变化。结果两组治疗后6个月，总胆固醇(TC)、低密度脂蛋白(LDL-C)水平均降低，治疗后6个月的强化降脂组比常规剂量组降低更明显(P<0.05)。两组CIMT均明显降低，强化降脂组CIMT比常规剂量组降低更明显，两组比较差异有统计学意义(均P<0.05)。不良反应比较差异无统计学意义。结论强化降脂治疗能更有效地降低TC、LDL-C和CIMT，且安全性良好。
[关键词] 脑梗死；阿托伐他汀；颈动脉
[中图分类号] R972+.6[文献标识码] B[文章编号] 1673-9701(2011)20-146-02
Effect of Intensive Lipid Lowering by Atorvastatin on Blood-fat and Carotid Arterial Intima-media Thickness in Patients with Cerebral Infarction
DONG Fen FU Guoping YU Dihong MA Li LU Guojian
Department of Neurology，the Second Hospital of Shaoxing City，Zhejiang Province，Shaoxing 312000，China
[Abstract] Objective To investigate the effect of intensive lipid lowering of atorvastation on blood-fat and carotid arterial intima-media thickness(CIMT)in patients with cerebral infarction. MethodsSixty cerebral infarction patients were randomized to atorvastatin 20mg/d intensive lipid lowing group(30 patients)and 10 mg/d common group(30 patients). Changes on blood-fat，CIMT by ultrasound before and after treatment were investigated after six months. Results The levels of cholesterol(TC)，low density lipoprotein cholesterol (LDL-C) in both groups were decreased，changes in group of 20mg/d were more obvious than in group of 10mg/d(P<0.05). CIMT were obviously cutted down in two groups，intensive lipid lowering group was reduced than that of common group(both P<0.05). The comparison of adverse reactions had not statistical significance. Conclusion Intensive treatment by atorvastatin more obviously decreases TC、LDL-C and CIMT，in patients with safely.
[Key words] Cerebral infarction；Atorvastatin；Carotid arteries
血清胆固醇水平、动脉硬化与脑梗死发病率、病死率显著相关，多项研究显示，应用他汀类药物除能有效降低血脂外，尚有非降脂外改善血管内皮功能、延缓动脉粥样硬化进程作用。目前国内对他汀类降脂药强化降脂治疗对脑梗死患者CIMT的影响的研究较少，本研究通过观察阿托伐他汀强化降脂对脑梗死患者血脂及CIMT的影响，进一步探讨他汀类降脂药改善动脉粥样硬化进程，降低脑梗死发生的疗效及安全性。
1资料与方法
1.1一般资料
选择本院2009年1月～2010年12月60例脑梗死患者，病程在1周内，诊断均符合全国第四届脑血管病协会制定的标准，全部经头颅CT或MRI证实的患者60例，所有脑梗死患者病因均为大动脉粥样硬化(按TOAST分型)。同时符合下列条件：无严重肝肾、心功能不全；1个月内未服用炎症抑制药物、免疫抑制剂及降脂药物 ......
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