【摘要】 目的探讨辛伐他汀对颈动脉粥样硬化的影响,以及其在预防脑梗死患者复发中的作用。方法将622例脑梗死患者分成阿司匹林治疗组与辛伐他汀治疗组,辛伐他汀治疗组在阿司匹林治疗的基础上加用辛伐他汀20mg,每晚1次。随访观察6~36月,观察脑梗死复发情况,并在治疗前及治疗后8~12周应用彩色多普勒超声对脑梗死患者的颈内动脉斑块和狭窄程度进行评估。结果根据随机分组,治疗前两组一般情况和脑梗死复发危险因素无差异(P>0.05),312例阿司匹林组患者在随访期复发61例(19.6%),而辛伐他汀组仅有32例(10.3%)复发,两组在统计学上有差异(P<0.05),在治疗前两组患者在颈内动脉粥样硬化程度、狭窄程度及斑块的超声病理分型等方面的比较,均无差异,治疗后辛伐他汀组颈动脉粥样硬化程度、狭窄程度以及软斑和溃疡斑块的发生率则明显降低,与治疗前比较有差异(P<0.05)。结论阿司匹林治疗的基础上加用辛伐他汀治疗能明显降低脑梗死复发率,辛伐他汀可能通过对颈动脉粥样硬化的影响而起到降低脑梗死复发的作用。更多还原

【Abstract】 Objective To explore the effects of statin on carotid atherosclerosis and the preventive role in recurrence cerebral infarction.Methods 622 patients with cerebral infarction were randomly divided into aspirin group(312 cases) and the simvastatin group(310 cases),and the patients in both groups were given aspirin as routine treatment,however,the patients in simvastatin group were also administered simvastatin 20 mg every night.The duration of follow-up was 6 to 36 months,and the carotid atherosclerosis of patients with cerebral infarction was assessed by doppler ultrasongraphy before and 8～12 weeks after treatment.Results 61 patients suffered new cerebral infarction during follow-up period in aspirin group(19.6%);On the other hand,32 patients suffered new cerebral infarction during follow-up period in the simvastatin group(10.3%).There was a significant difference between the two groups(P<0.05).There was no significant difference between two groups in risk factors,the severe grade of carotid atherosclerosis,the degree of carotid stenosis and characteristics of plaque before treatment(P>0.05).The severe grade of carotid atherosclerosis and the degree of carotid stenosis and soft plaque or ulcerated plaque were significantly decreased after 8～12 week’s treatment in the simvastatin group(P<0.05). Conclusions Simvastatin can decrease the recurrence rate of cerebral infarction on the basis of aspirin treatment,it possibly due to improving the carotid atherosclerosis.更多还原