預防性應用他汀類藥物對老年急性腦梗死短期預后的影響

李健飛 沈閑茹 袁丹

[摘要]目的 探討預防性應用他汀類藥物對老年急性腦梗死短期預后的影響。方法 選取2016年6月～2017年6月我院收治的年齡>60歲的89例急性腦梗死患者作為研究對象，采用病例對照研究的方法分為觀察組（45例）和對照組（44例）。觀察組發(fā)病前應用他汀類藥物（阿托伐他汀10 mg/d）半年以上，對照組則未應用。比較兩組患者入院時的危險因素、空腹血糖、糖化血紅蛋白、血脂水平、神經功能缺損情況，兩組給予相同治療方案治療2周后評估神經功能缺損情況。結果 兩組入院時的危險因素、空腹血糖及美國國立衛(wèi)生研究院卒中量表（NIHSS）評分比較，差異無統(tǒng)計學意義（P>0.05）;觀察組的三酰甘油、總膽固醇、低密度脂蛋白膽固醇水平及治療2周后的NIHSS評分低于對照組，高密度脂蛋白膽固醇水平高于對照組，差異有統(tǒng)計學意義（P<0.05）。結論 預防性應用他汀類藥物能改善老年急性腦梗死患者起病短期內的血脂水平及神經缺損功能，減輕致殘程度。

[關鍵詞]老年;腦梗死;他汀類藥物;預后

[中圖分類號] R743.3? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-4721（2019）8（a）-0045-03

[Abstract] Objective To investigate the influence of preventive use of statins on the short-term prognosis of acute cerebral infarction in the elderly patients. Methods A total of 89 patients with acute cerebral infarction aged over 60 years in our hospital from June 2016 to June 2017 were selected as the research objects. The patients were divided into the observation group （45 cases） and the control group （44 cases） by case-control study. The observation group was treated with statins （Atorvastatin 10 mg/d） for more than half a year before onset， while the control group was not. The risk factors， fasting blood glucose， glycosylated hemoglobin， blood lipid level and neurological defects of the two groups were compared at the time of admission， and the neurological defects were evaluated at 2 weeks after the same treatment regimen in the two groups. Results There was no significant difference in risk factors， fasting glucose and the national institutes of health stroke scale （NIHSS） scores between the two groups at admission （P>0.05）. The levels of triglyceride， total cholesterol， low density lipoprotein cholesterol and NIHSS score after 2 weeks of treatment in the observation group were lower than those in the control group， while the levels of high density lipoprotein cholesterol in the observation group were higher than those in the control group， the differences were statistically significant （P<0.05）. Conclusion Preventive use of statin drugs can improve the onset of lipid levels and nerve defects of the elderly patients with acute cerebral infarction in the short term， reduce the degree of disability.

[Key words] Old age; Cerebral infarction; Statins; Prognosis

隨著我國生活及醫(yī)療水平的逐年提高，平均預期壽命快速增長，2015年人口預期壽命增長達到了76.34歲，已經接近發(fā)達國家水平[1]。人口老年化隨之而來的是多種慢性疾病發(fā)病率增加，腦梗死為其中之一，約占全部腦血管病變的70%。目前認為其主要原因為腦動脈粥樣硬化，而導致動脈粥樣硬化發(fā)生是由長期多種因素共同作用的結果，高齡就是危險因素之一[2]。他汀類藥物普遍應用于心腦血管病變二級預防，但有臨床研究結果顯示，他汀類藥物預防治療能夠減輕急性腦梗死所致殘障，減少死亡率[3]。本研究旨在探討預防性應用他汀類藥物對于老年患者出現(xiàn)腦梗死預后的影響，現(xiàn)將研究結果報道如下。