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目的观察阿托伐他汀对血脂正常的缺血性脑卒中患者早期炎症因子和脑血管事件的干预效果。方法94例血脂正常的缺血性脑卒中患者,随机分为阿托伐他汀治疗组和常规治疗对照组(各47例),另选择同期40例健康者作为健康对照组,分析比较组间阿托伐他汀治疗(20mg/d×6个月)前和治疗后2、4周高敏C-反应蛋白(hs-CRP)和血脂水平的变化,同时观察患者住院和半年随访期间主要脑血管病事件发生情况。结果两组缺血性脑卒中患者血脂水平与健康对照组比较差异无统计学意义,但其hs-CRP水平显著高于健康对照组(P均<0.01);治疗2周后hs-CRP显著降低(P均<0.01);治疗4周后胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及hs-CRP均显著降低(P均<0.01),且低于常规治疗对照组(P均<0.05);阿托伐他汀治疗组住院及半年随访期间缺血性脑卒中发生率较常规治疗组显著降低(P均<0.05)。结论血脂正常的缺血性脑卒中患者存在炎症反应,阿托伐他汀早期治疗能够抑制炎症因子,降低住院和半年随访期间缺血性脑卒中的致残、致死率和复发率。
Objective To observe the effect of atorvastatin on the early inflammatory factors and cerebrovascular events in patients with normal blood lipids and ischemic stroke. Methods Ninety-four patients with normotensive ischemic stroke were randomly divided into two groups: atorvastatin group (n = 47) and conventional treatment group (n = 47), and another 40 healthy subjects were selected as healthy control group The changes of high-sensitivity C-reactive protein (hs-CRP) and blood lipid levels before and at 2, 4 weeks after treatment with atorvastatin (20mg / d × 6months), and the main cerebrovascular disease events during hospitalization and six months follow-up What happened? Results The serum levels of hs-CRP were significantly higher in ischemic stroke patients than those in healthy controls (P <0.01). The levels of hs-CRP were significantly decreased after 2 weeks of treatment (P <0.01). After 4 weeks of treatment, the levels of cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and hs-CRP were significantly lower than those of the control group (P <0.01) <0.05). The incidence of ischemic stroke was significantly lower in the atorvastatin group and the half-year follow-up than that in the conventional treatment group (all P <0.05). Conclusions Inflammatory reaction is present in patients with normal blood lipid and stroke. Early treatment with atorvastatin can inhibit inflammatory cytokines and reduce the disability, mortality and relapse rate of ischemic stroke during hospitalization and six months’ follow-up.