目的 探討阿托伐他汀強(qiáng)化治療腦梗死的臨床療效。方法 選取2018年9月-2019年8月在上海市楊浦區(qū)市東醫(yī)院治療的腦梗死患者78例，隨機(jī)分為對(duì)照組和治療組，每組各39例。對(duì)照組口服阿托伐他汀鈣片，20 mg/次，1次/d；治療組口服阿托伐他汀鈣片，40 mg/次，1次/d。兩組患者均治療4周。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者三酰甘油（TG）、膽固醇（TC）、低密度脂蛋白膽固醇（LDL-C）和高密度脂蛋白膽固醇（HDL-C）水平，NIHSS評(píng)分和Barthel指數(shù)，及血清基質(zhì)金屬蛋白酶-7（MMP-7）、MMP-8和MMP-12水平。結(jié)果 治療后，對(duì)照組臨床有效率為79.49%，顯著低于治療組的94.87%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組TC、TG和LDL-C水平顯著下降（P<0.05），HDL-C水平顯著上升（P<0.05），且治療組明顯好于對(duì)照組（P<0.05）。治療后，兩組患者NIHSS評(píng)分顯著下降（P<0.05），Barthel指數(shù)顯著上升（P<0.05），且治療組NIHSS評(píng)分和Barthel指數(shù)明顯好于對(duì)照組（P<0.05）。治療后，兩組血清MMP-7、MMP-8和MMP-12指標(biāo)顯著下降（P<0.05），且治療組明顯低于對(duì)照組（P<0.05）。結(jié)論 阿托伐他汀強(qiáng)化治療腦梗死患者的療效確切，能更有效控制血脂水平，改善神經(jīng)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

上海市衛(wèi)生和計(jì)劃生育委員會(huì)科研課題計(jì)劃項(xiàng)目（2017450）