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目的:观察阿托伐他汀对血脂水平正常急性脑梗死患者神经功能缺损及颈动脉内膜-中膜厚度的影响。方法:血脂水平在正常范围首次发生脑梗死患者226例,随机分为治疗组(115例)和对照组(111例),对照组给予常规治疗,治疗组在常规治疗基础上给予阿托伐他汀20mg/次,1次/d,口服,疗程12个月。分别于入院后第1d、治疗后第6个月、第12个月清晨空腹抽血检测血脂水平,谷草转氨酶及血清肌酸激酶值;彩色超声诊断仪检测局部动脉粥样硬化区域内膜-中层厚度,进行神经功能缺损评分和巴塞尔评分。结果:治疗组治疗6个月时总胆固醇、低密度脂蛋白胆固醇水平、神经功能缺损评分较对照组明显降低,而高密度脂蛋白胆固醇水平及巴塞尔评分则较对照组显著升高,差异有统计学意义(P<0.05),而2组三酰甘油水平、动脉内膜-中层厚度差异无统计学意义(P>0.05);治疗12个月时与对照组相比,三酰甘油、总胆固醇、低密度脂蛋白胆固醇水平、神经功能缺损评分、颈动脉内膜-中层厚度显著降低,而高密度脂蛋白胆固醇、巴塞尔评分则明显升高,差异有统计学意义(P<0.05)。结论:阿托伐他汀有明确不依赖调脂的脑保护作用,有助于脑梗死后神经功能的恢复,可以提高动脉粥样硬化斑块稳定性,具有抗粥样硬化作用。
Objective: To observe the effect of atorvastatin on neurological impairment and intima-media thickness of carotid artery in patients with normal blood lipids and normal acute cerebral infarction. Methods: A total of 226 patients with cerebral infarction were included in this study. One hundred and twenty-two patients with cerebral infarction were included in the normal range. The patients in the control group were given routine treatment. The patients in the treatment group were given atorvastatin 20mg / time, 1 time / d, oral, treatment for 12 months. Serum lipids, AST and serum creatine kinase (AST) and serum creatine kinase (CK-MB) were measured on the first day after admission, on the 6th month and 12th month after the treatment respectively. Color ultrasound was used to detect the intima-media thickness of the local atherosclerosis Thickness, neurological deficit score and Basel score. Results: The levels of total cholesterol, low density lipoprotein cholesterol and neurological deficit in the treatment group were significantly lower than those in the control group at 6 months, while the levels of high-density lipoprotein cholesterol and Basel score were significantly higher than those in the control group (P <0.05). There were no significant differences in triglyceride levels and arterial intima-media thickness between the two groups (P> 0.05). Compared with the control group, triglyceride, Cholesterol, low density lipoprotein cholesterol, neurological deficit score and intima-media thickness of carotid arteries decreased significantly, while high-density lipoprotein cholesterol and Basel score increased significantly, with statistical significance (P <0.05). Conclusions Atorvastatin has a clear and independent protective effect on lipid-lowering brain and helps to restore the neurological function after cerebral infarction. It can enhance the stability of atherosclerotic plaque and has anti-atherosclerotic effect.