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[摘要]
目的 比较分析不同剂量阿托伐他汀钙对脑梗死患者血清炎症因子及颈动脉斑块的影响。方法 选择2014年1月-2015年6月在西安市第四医院接受治疗的178例脑梗死患者,根据用药剂量的不同分为低剂量组90例和高剂量组88例。低剂量组患者在基础治疗上,给予阿托伐他汀钙10 mg/d治疗;高剂量组也给予患者阿托伐他汀钙20 mg/d治疗,所有患者均给予6个月治疗。比较分析两组患者治疗前后的血脂水平,包括总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG);血清炎症因子水平,包括高敏C-反应蛋白(hs-CRP)、血浆白细胞介素6(Interleukin-6,IL-6)、肿瘤坏死因子(TNF-α),以及颈动脉粥样硬化斑块指标的变化情况。结果 治疗6个月后,所有患者的血脂水平较治疗前均有显著性改善,差异有统计学意义(P<0.05);且高剂量组的血脂水平显著优于低剂量组,差异有统计学意义(P<0.05)。所有患者的血清炎症因子水平较治疗前均有显著性改善,差异有统计学意义(P<0.05);且高剂量组的血清炎症因子水平显著低于低剂量组,差异有统计学意义(P<0.05)。此外,低剂量组动脉粥样硬化指标较治疗前无明显改善,但高剂量组较治疗前有明显降低,且显著低于低剂量组,比较差异有统计学意义(P<0.05)。结论 阿托伐他汀钙有助于改善脑梗死患者的血脂水平、血清炎症因子以及颈动脉粥样硬化斑块,而20 mg/d给药剂量临床效果更为明显。
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[Abstract]
Objective To investigate the effect of atorvastatin calcium with different doses on inflammatory cytokine and carotid atherosclerotic plaque of patients with cerebral infarction. Methods One hundred and seventy-eight patients with cerebral infarction admitted into our hospital from January 2014 to June 2015 were divided into low dose (LD) group and high dose (HD) group. Ninety patients in LD group were treated with atorvastatin calcium in a dose of 10 mg/d, and eighty-seven patients in HD group were treated with atorvastatin calcium in a dose of 20 mg/d. The serum levels of lipid including TC, TG, LDL-C, HDL-C, inflammatory cytokine including hs-CRP, IL-6, TNF-α, and carotid atherosclerotic plaque of both groups were analyzed and compared before and after treatment. Results After six months of treatment, the serum levels and inflammatory cytokine of patients in both groups showed remarkable improvement (P<0.05), and those in HD group were significantly better than those of LD group (P<0.05). Additionally, compared with those before treatment, changes in carotid atherosclerotic plaque of patients in LD group were not obvious, while those in HD group markedly decreased, and which were significantly lower than those of LD group (P<0.05). Conclusion Atorvastatin calcium with HD of 20 mg/d showed a better capability on improving serum levels of lipid, inflammatory cytokine, and carotid atherosclerotic plaque of patients with cerebral infarction than those with LD of 10 mg/d.
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