阿托伐他汀联用阿司匹林预防缺血性脑卒中复发300例临床分析

目的观察研究缺血性脑卒中患者服用阿托伐他汀治疗后,颈动脉粥样硬化变化情况及缺血性脑卒中复发情况。方法将300例缺血性脑卒中患者随机分成2组,每组150例,两组常规治疗方法相同,对照组阿司匹林10mg/d,治疗组在此基础上加用阿托伐他汀20mg/d。随访12个月,了解缺血性脑卒中复发情况,并在治疗之前及治疗之后2～3月进行颈动脉彩超检查,对比治疗前后缺血性脑卒中患者颈内动脉斑块、狭窄程度等改变情况。结果对照组150例复发率18.67%,治疗组复发率6.00%,差异有显著性(P<0.05)。治疗后治疗组病人颈动脉粥样硬化、狭窄及软斑发生均明显改变,与治疗前比较,差异有统计学意义(P<0.05)。结论阿托伐他汀和阿司匹林联合治疗能显著降低缺血性脑卒中复发率,阿托伐他汀主要是通过对颈动脉粥样硬化的干预起到防止脑血栓形成,从而降低缺血性脑卒中的复发。

Analysis of 300 clinical cases of effect of atorvastatin to cerebral ischemic stroke

Objective To observe the influence of atorvastatin to carotid atherosclerosis and its contribution to preventing the recrudescence of cerebral ischemic stroke.Method 300 patients were randomly divided into two groups,each 150 cases.The patients in study group were treated by aspirin and atorvastatin 20 mg orally,once a night,and the control group were treated by aspirin only.Then we should follow up 12 months,observe the recrudescence of cerebral ischemic stroke,and check carotid duplex ultrasound before treatment and 2-3 months after therapy,to evaluate the carotid atherosclerotic plaque and the degree of carotid stenosis of patients with cerebral ischemic stroke.Result Only 6.00% patients recrudesced in study group,while 18.67% patients recrudesced in control group.The difference is significant(P<0.05).the severity of carotid atherosclerosis、the degree of stenosis and the incidence of soft plaques were all significantly decreased after the treatment in atorvastatin group,(P<0.05).Conclusion Aspirin and atorvastatin significantly reduces the recrudescent rate of cerebral ischemic stroke.Atorvastatin can reduce the recrudescence of cerebral ischemic stroke from the effect to the carotid atherosclerosis.