【摘要】 目的比较阿托伐他汀与辛伐他汀对急性脑梗死患者血清超敏C反应蛋白(hs-CRP)、血脂及颈动脉粥样硬化斑块的影响。方法选取自2013年1月至2015年1月陕西省人民医院就诊的急性脑梗死患者66例及体检中心健康体检者33例作为研究对象。将脑梗死患者66例随机分为A、B两组,每组各33例,A组给予急性脑梗死常规治疗+阿托伐他汀20 mg/d,B组给予急性脑梗死常规治疗+辛伐他汀40 mg/d;健康体检者33例为C组。急性脑梗死患者(A组+B组)随访6个月。比较3组的hs-CRP、颈动脉内膜中层厚度、丙二醛、氧化型低密度脂蛋白、血脂、颅内动脉血流动力学及心脑血管事件发生率。结果治疗前,急性脑梗死患者(A组+B组)的hs-CRP水平显著高于C组,差异具有统计学意义(P<0.05)。治疗后,A组、B组的hs-CRP、颈动脉内膜中层厚度、丙二醛、氧化型低密度脂蛋白、总胆固醇、甘油三酯、低密度脂蛋白水平明显低于治疗前,差异有统计学意义(P<0.05);A组的hs-CRP、颈动脉内膜中层厚度、丙二醛、氧化型低密度脂蛋白、总胆固醇、甘油三酯、纤维蛋白原、全血高切黏度、全血低切黏度、血细胞比容、血浆黏度水平明显低于B组,差异有统计学意义(P<0.05);A组的低密度脂蛋白水平明显高于B组,差异有统计学意义(P<0.05);A、B两组心脑血管事件发生率比较,差异无统计学意义(P>0.05)。结论阿托伐他汀与辛伐他汀均能显著降低急性脑梗死患者hs-CRP及血脂水平,抑制颈动脉粥样硬化斑块的形成;且阿托伐他汀的抗炎性反应及降脂作用比辛伐他汀更强。更多还原

【Abstract】 Objective To investigate the comparative effects of atorvastatin and simvastatin on serum high sensitivity C-reactive protein( hs-CRP),lipid and carotid atherosclerotic plaques of patients with acute cerebral infarction. Methods A retrospective study was performed on 66 patients with acute cerebral infarction received in Shanxi Provincial People’ s Hospital and 33 healthy volunteers received health examination in medical examination center from January 2013 to January 2015. The 66 patients with acute cerebral infarction were randomly divided into Group A and Group B with 33 cases in each group,and 33 healthy volunteers were in Group C. Patients of Group A were given conventional treatment of cerebral infarction combined atorvastatin 20 mg / day,and patients of Group B were given conventional treatment of cerebral infarction combined simvastatin 40 mg / day. The patients with acute cerebral infarction(Group A and Group B) were followed up for 6 months. The hs-CRP,carotid intima-media thickness,malondialdehyde,oxidized low density lipoprotein,blood lipids,intracranial arterial blood flow mechanics and incidence of cardiovascular events were compared among the three groups. Results Before treatment,the hs-CRP level of patients with cerebral infarction( Group A and Group B) was significantly higher than that in Group C,and the difference was statistically significant( P < 0. 05). After treatment,the hs-CRP,carotid intima-media thickness,malondialdehyde,oxidized low density lipoprotein,total cholesterol,triglyceride,low density lipoprotein levels were significantly lower than those before treatment,and the differences were statistically significant( P < 0. 05);the hs-CRP,carotid intimamedia thickness,malondialdehyde,oxidized low density lipoprotein,total cholesterol,triglyceride,fibrinogen,whole blood high shear viscosity,whole blood low shear viscosity,hematocrit and plasma viscosity level of Group A were significantly lower than those of Group B,and the differences were statistically significant( P < 0. 05);the low density lipoprotein level of group A was significantly higher than that of group B,and the difference was statistically significant( P < 0. 05);the incidence of cardiovascular events between Group A and Group B,there was no statistically significant difference( P > 0. 05). Conclusion Both of atorvastatin and simvastatin can significantly reduce hs-CRP and blood lipid levels of patients with acute cerebral infarction,inhibit the formation of carotid atherosclerotic plaques;the anti inflammatory reaction and lipid-lowering effect of atorvastatin is superior to simvastatin.更多还原