内科

目的探讨不同剂量阿托伐他汀钙治疗对脑梗死急性期患者血管内皮功能、神经功能和血脂水平的影响。方法选取2016年3月至2017年9月我院收治的脑梗死急性期患者123例，采用随机数字表法分为A组、B组和C组，每组41例。A组患者口服阿托伐他汀钙20 mg/次，1次/d；B组患者口服阿托伐他汀钙40 mg/次，1次/d；C组患者口服阿托伐他汀钙60 mg/次，1次/d，疗程均为2周。比较三组患者治疗前后的神经缺损功能（NIHSS）评分、日常生活活动能力（ADL）评分、血管内皮功能和血脂水平。结果治疗2周后，三组患者的NIHSS评分均显著下降（P＜0.05），C组患者NIHSS评分最低，三组比较差异均有统计学意义（P＜0.05）；三组患者的ADL评分均显著增加，C组患者的ADL评分最高，三组比较差异有统计学意义（P＜0.05）；三组患者的NO水平均显著升高、ET-1水平均显著下降，C组患者的NO水平最高、ET-1水平最低，三组患者的NO、ET-1水平比较差异有统计学意义（P＜0.05）；三组患者的LDL-C、TG、TC水平均显著降低、HDL-C水平均显著升高（P＜0.05），C组患者的LDL-C、TG、TC水平最低、HDL-C水平最高，三组患者的LDL-C、TG、TC、HDL-C水平比较差异有统计学意义（P＜0.05）。结论高剂量（60 mg/d）阿托伐他汀钙治疗脑梗死急性期患者的效果明显优于低剂量（≤40 mg/d）治疗，可更有效地改善患者的神经功能、血管内皮功能和血脂水平。

ObjectiveTo investigate the effects of different doses of atorvastatin calcium on vascular endothelial function, nerve function and blood lipid in patients with acute cerebral infarction. Methods123 patients with acute cerebral infarction treated in our hospital from March 2016 to September 2017 were selected as the subjects. According to random table method, they were divided into group A, group B and group C, with 41 cases in each group. Group A were treated with atorvastatin calcium 20 mg/d, once a day; group B were treated with atorvastatin calcium 40 mg/d, once a day； group C were treated with atorvastatin calcium 60 mg/d, once a day. 2 weeks as a course of treatment. The national institute of health stroke scale (NIHSS) score, activities of daily living (ADL) score, vascular endothelial function and blood lipid level were compared between the three groups before and after treatment. ResultsAfter 2 weeks of treatment, the NIHSS score of the three groups were decreased (P＜0.05), while the NIHSS score in group C was lowest, the difference between three groups were statistically significant (P＜0.05); the ADL score of the three groups were increased (P＜0.05), while the ADL score of group C was highest, the difference between three groups were statistically significant (P＜0.05). The NO level of the three groups increased, while the level of ET-1 decreased (P＜0.05). The level of NO in group C was highest, while ET level was lowest, the difference levels of NO and ET-1 between three groups were statistically significant (P＜0.05). The levels of LDL-C, TG and TC in three groups were decreased and HDL-C level increased(P＜0.05), and the levels of LDL-C, TG and TC in group C after treatment was lowest, while the level of HDL-C is highest, the difference levels of LDL-C, TG, TC and HDL-C between three groups were statistically significant (P＜0.05). ConclusionHigh dose (60 mg/d) atorvastatin calcium has obvious effect on acute stage of cerebral infarction, and which improves neurological function, vascular endothelial function and blood lipid level.