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目的比较不同剂量阿托伐他汀钙片治疗缺血性脑血管病的临床疗效和安全性。方法将40例颈部血管存在斑块患者随机分为对照组20例和试验组20例。对照组予以阿托伐他汀钙20 mg,qd,睡前口服;试验组予以阿托伐他汀钙40 mg,qd,睡前口服。2组患者均治疗6个月。比较2组患者的临床疗效、血脂、颈部血管斑块水平,以及药物不良反应的发生情况。结果治疗后6个月,试验组和对照组的总有效率为分别95.00%(19例/20例)和85.00%(17例/20例),差异有统计学意义(P>0.05)。治疗后3,6个月,试验组的总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)分别为(2.61±0.31),(1.32±0.23),(1.98±0.31)mmol·L~(-1)和(2.23±0.27),(1.06±0.21),(1.75±0.26)mmol·L~(-1);颈部血管斑块的斑块长度、斑块厚度和斑块面积分别为(7.08±0.17)mm,(1.27±0.15)mm,(8.99±1.10)mm~2和(6.76±0.21)mm,(1.18±0.26)mm,(8.01±1.14)mm~2。对照组治疗后的3,6个月的TC、TG、LDL-C分别为(3.67±0.47),(1.56±0.29),(2.63±0.27)mmol·L~(-1)和(3.54±0.41),(1.42±0.25),(2.37±0.31)mmol·L~(-1);颈部血管斑块的斑块长度、斑块厚度和斑块面积分别为(7.87±0.23)mm,(1.83±0.14)mm,(14.40±3.62)mm~2和(7.21±0.35)mm,(1.34±0.31)mm,(9.66±1.25)mm~2。2组患者的上述指标比较,差异均有统计学意义(均P<0.05)。试验组出现腹胀1例次,对照组出现恶心1例次,2组患者的药物不良反应发生率均为5.00%,差异无统计学意义(P>0.05)。结论阿托伐他汀钙40 mg治疗缺血性脑血管病的临床疗效与阿托伐他汀钙片20 mg相当,然而前者在降脂和逆转颈部血管斑块方面的优势更加明显,且不增加药物不良反应的发生率。
Objective To compare the clinical efficacy and safety of different doses of atorvastatin calcium tablets in the treatment of ischemic cerebrovascular disease. Methods Forty patients with plaque in the neck were randomly divided into control group (20 cases) and experimental group (20 cases). The control group was given atorvastatin calcium 20 mg qd, before bedtime oral; the experimental group was given atorvastatin calcium 40 mg qd, before going to bed orally. Two groups of patients were treated for 6 months. The clinical efficacy, blood lipids, the level of cervical vascular plaque, and the incidence of adverse drug reactions were compared between the two groups. Results At 6 months after treatment, the total effective rate was 95.00% (19 cases / 20 cases) and 85.00% (17 cases / 20 cases) in experimental group and control group, respectively. The difference was statistically significant (P> 0.05). The total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) in the experimental group were (2.61 ± 0.31), (1.32 ± 0.23) and ± 0.31) mmol·L -1 and (2.23 ± 0.27), (1.06 ± 0.21) and (1.75 ± 0.26) mmol·L -1, respectively. The length of plaque (7.08 ± 0.17) mm, (1.27 ± 0.15) mm, (8.99 ± 1.10) mm ~ 2 and (6.76 ± 0.21) mm, (1.18 ± 0.26) mm, (8.01 ± 1.14) mm ~ 2. The levels of TC, TG and LDL-C at 3 and 6 months after treatment in the control group were (3.67 ± 0.47), (1.56 ± 0.29), (2.63 ± 0.27) mmol·L -1 and (3.54 ± 0.41 ), (1.42 ± 0.25) and (2.37 ± 0.31) mmol·L -1, respectively. The plaque length, plaque thickness and plaque area of the cervical vascular plaque were (7.87 ± 0.23) mm and ± 0.14) mm, (14.40 ± 3.62) mm ~ 2 and (7.21 ± 0.35) mm, (1.34 ± 0.31) mm and (9.66 ± 1.25) mm ~ 2.2 The difference was statistically significant Significance (all P <0.05). One case of abdominal distension was found in the experimental group and one case of nausea in the control group. The incidence of adverse drug reactions in both groups was 5.00%, with no significant difference (P> 0.05). Conclusions The clinical efficacy of 40 mg atorvastatin calcium in the treatment of ischemic cerebrovascular disease is comparable to that of 20 mg atorvastatin calcium tablets. However, the former has more obvious advantages in lipid lowering and reversal of cervical vascular plaque with no increase The incidence of adverse drug reactions.