目的 探讨阿托伐他汀强化治疗脑梗死的临床疗效。方法 选取2018年9月-2019年8月在上海市杨浦区市东医院治疗的脑梗死患者78例，随机分为对照组和治疗组，每组各39例。对照组口服阿托伐他汀钙片，20 mg/次，1次/d；治疗组口服阿托伐他汀钙片，40 mg/次，1次/d。两组患者均治疗4周。观察两组患者临床疗效，同时比较治疗前后两组患者三酰甘油（TG）、胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）水平，NIHSS评分和Barthel指数，及血清基质金属蛋白酶-7（MMP-7）、MMP-8和MMP-12水平。结果 治疗后，对照组临床有效率为79.49%，显著低于治疗组的94.87%，两组比较差异有统计学意义（P<0.05）。治疗后，两组TC、TG和LDL-C水平显著下降（P<0.05），HDL-C水平显著上升（P<0.05），且治疗组明显好于对照组（P<0.05）。治疗后，两组患者NIHSS评分显著下降（P<0.05），Barthel指数显著上升（P<0.05），且治疗组NIHSS评分和Barthel指数明显好于对照组（P<0.05）。治疗后，两组血清MMP-7、MMP-8和MMP-12指标显著下降（P<0.05），且治疗组明显低于对照组（P<0.05）。结论 阿托伐他汀强化治疗脑梗死患者的疗效确切，能更有效控制血脂水平，改善神经功能，提高日常生活能力。

Objective To explore the clinical effect of intensive treatment of brain infarction with atorvastatin. Methods Patients (78 cases) with cerebral infarction in Shanghai Yangpu Shidong Hospital from September 2018 to August 2019 were randomly divided into control and treatment groups, and each group had 39 cases. Patients in the control group were po administered with Atorvastatin Calcium Tablets, 20 mg/time, once daily. Patients in the treatment group were po administered with Atorvastatin Calcium Tablets, 40 mg/time, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the levels of TG, TC, LDL-C and HDL-C, NIHSS scores and Barthel indexes, and the levels of MMP-7, MMP-8 and MMP-12 in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 79.49%, which was significantly lower than 94.87% in the treatment group, and there were differences between two groups (P < 0.05). After treatment, the levels of TC, TG and LDL-C in two groups were significantly decreased (P < 0.05), but the HDL-C levels were significantly increased (P < 0.05), and the blood lipid levels in the treatment group were significantly better than that in the control group (P < 0.05). After treatment, the NIHSS scores in two groups were significantly decreased (P < 0.05), but the Barthel indexes were significantly increased (P < 0.05), and these indicators in the treatment group were significantly better than that in the control group (P < 0.05). After treatment, the serum levels of MMP-7, MMP-8 and MMP-12 in two groups were significantly decreased (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusions Intensive treatment of cerebral infarction with atorvastatin is effective, can significantly control blood lipid level, improve nerve coagulation and improve ability of daily living.

R971

上海市卫生和计划生育委员会科研课题计划项目（2017450）