摘要
目的评价匹伐他汀与阿托伐他汀对缺血性脑卒中(IS)患者血脂调控的疗效,对比其改善IS患者颈动脉粥样硬化效力的差异。方法 2012年3月至2013年2月在北京大学人民医院选择急性脑梗死患者70例随机分为2组,匹伐他汀组40例,接受匹伐他汀治疗,每晚2 mg,其中前循环梗死23例,后循环梗死14例,分水岭梗死3例;阿托伐他汀组30例,接受阿托伐他汀治疗,每晚10 mg,其中前循环梗死16例,后循环梗死14例。从入组开始治疗共6个月。分别于治疗前、治疗后2周、1个月、3个月及6个月末随访,记录疗效观察指标(血脂水平、双侧颈动脉内中膜厚度),安全性观察指标(血、尿常规,肝肾功能,空腹血糖,肌酸激酶,心电图),神经功能观察指标(NIHSS和m RS评分)。采用SPSS 19.0统计软件进行检验,P<0.05为差异有统计学意义。结果治疗6个月后,匹伐他汀组LDL-C显著下降(t=4.01,P<0.01),下降幅度为18.5%,阿托伐他汀组下降幅度为21.0%(t=4.56,P<0.01),两组间无显著差异(t=1.92,P=0.059)。匹伐他汀组右颈总动脉内膜中层厚度(IMT)有所减少(t=1.92,P=0.063),并且软斑数量有所减少(χ2=0.33,P=0.85),但与治疗前比较,差异均无统计学意义(P<0.05)。两组患者心电图、尿蛋白、空腹血糖、血肌酸激酶、丙氨酸转氨酶、转肽酶以及肌酐水平治疗前后均无显著变化(P<0.05)。结论匹伐他汀降低LDL-C的作用和治疗颈动脉粥样硬化的远期作用可能与阿托伐他汀相当,不良反应较轻微,可用于IS患者高胆固醇血症和动脉粥样硬化的治疗。
Objective To evaluate the efficacy about lipid regulation of pitavastatin and atorvastatin in treatment of patients with ischemic stroke, contrast to improve in the effectiveness of carotid atherosclerosis in patients with ischemic stroke.Methods The selected 70 patients with acute cerebral infarction were randomly divided into 2 groups,pitavastatin 2mg/night in 40 cases, including 23 patients with before circulation infarction patients, 14 patients with posterior circulation infarction, 3 patients with watershed infarction; atorvastatin 10 mg/night in 30 cases, including 16 patients with before circulation infarction patients, 14 patients with posterior circulation infarction. The total of treatment period is 6 months. Respectively before and after treatment for 2 weeks, 1 month, 3 months and 6 month follow-up, we record curative effect observation record index (lipid levels, bilateral carotid intima-media thickness), safety observation index (blood, urine routine, liver and kidney function, fasting blood glucose, creatine kinase, electrocardiogram), neurologic outcome (NIHSS and mRS score).Using SPSS statistical software to test 19.0, P < 0.05 for the difference was statistically signiifcant.Results After 6 months, LDL cholesterol (LDL-C) in pitavastatin treatment group significantly decreased by 18.5%(t=4.01,P<0.01), and LDL-C in the atorvastatin group significantly decreased by 21.0%(t=4.56,P<0.01), the LDL-C reduction were not significant difference between two groups (t=1.92,P=0.059). Pitavastatin treatment group after 6 months of right common carotid arteryIMT has decreased(t=1.92,P=0.063), and the soft plaque quantity decreased (χ2=0.33,P=0.85), but there was no statistically significant difference. Two groups of patients before and after treatment of electrocardiogram, urine routine, creatine phosphokinase, transaminase and serum creatinine levels had no significant change (P>0.05). Conclusions Pitavastatin may be similar to atorvastatin in reduction of LDL-C and the long-term effect of treatment of car
出处
《中华脑血管病杂志（电子版）》
2014年第1期1-8,共8页
Chinese Journal of Cerebrovascular Diseases(Electronic Edition)
关键词
卒中
颈动脉狭窄
降血脂药
Stroke
Carotid stenosis
Hypolipidemic agents
