李健飛 沈閑茹 袁丹

[摘要]目的 探討預(yù)防性應(yīng)用他汀類藥物對老年急性腦梗死短期預(yù)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(yīng)用他汀類藥物（阿托伐他汀10 mg/d）半年以上，對照組則未應(yīng)用。比較兩組患者入院時(shí)的危險(xiǎn)因素、空腹血糖、糖化血紅蛋白、血脂水平、神經(jīng)功能缺損情況，兩組給予相同治療方案治療2周后評(píng)估神經(jīng)功能缺損情況。結(jié)果 兩組入院時(shí)的危險(xiǎn)因素、空腹血糖及美國國立衛(wèi)生研究院卒中量表（NIHSS）評(píng)分比較，差異無統(tǒng)計(jì)學(xué)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(píng)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(jì)學(xué)意義（P<0.05）。結(jié)論 預(yù)防性應(yīng)用他汀類藥物能改善老年急性腦梗死患者起病短期內(nèi)的血脂水平及神經(jīng)缺損功能，減輕致殘程度。

[關(guān)鍵詞]老年;腦梗死;他汀類藥物;預(yù)后

[中圖分類號(hào)] R743.3? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 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(yù)期壽命快速增長，2015年人口預(yù)期壽命增長達(dá)到了76.34歲，已經(jīng)接近發(fā)達(dá)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(rèn)為其主要原因?yàn)槟X動(dòng)脈粥樣硬化，而導(dǎo)致動(dòng)脈粥樣硬化發(fā)生是由長期多種因素共同作用的結(jié)果，高齡就是危險(xiǎn)因素之一[2]。他汀類藥物普遍應(yīng)用于心腦血管病變二級(jí)預(yù)防，但有臨床研究結(jié)果顯示，他汀類藥物預(yù)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(yù)防性應(yīng)用他汀類藥物對于老年患者出現(xiàn)腦梗死預(yù)后的影響，現(xiàn)將研究結(jié)果報(bào)道如下。