目的 探讨大剂量瑞舒伐他汀对大动脉粥样硬化型脑卒中转归的影响.方法 选取大动脉粥样硬化型脑卒中患者82例,随机分为大剂量组39例与常规剂量组43例,检查2组血脂及高敏C反应蛋白(hs-CRP)水平,评估2组临床转归.结果 2组病死率、复发率及出血性转化发生率比较,差异无统计学意义(P＞0.05),大剂量组转归良好率明显高于常规剂量组(84.62％ vs 65.12％,P=0.04).与治疗前比较,治疗后常规剂量组与大剂量组hs-CRP水平均明显降低[(0.56±0.60)mg/L vs (0.70±0.68) mg/L,P=0.01;(0.22±0.29)mg/L vs (0.69±0.58)mg/L,P=0.00].治疗后与常规剂量组比较,大剂量组hs-CRP水平[(0.22±0.29)mg/Lvs (0.56±0.60)mg/L,P=0.00]显著降低,LDLC＜1.8 mmol/L(69.23％ vs 46.51％,P=0.04)、非HDL-C＜2.6 mmol/L(66.67％ vs 41.86％,P=0.03)比例明显升高.2组均未出现横纹肌溶解等严重不良反应.结论 大剂量瑞舒伐他汀治疗大动脉粥样硬化型脑卒中,可显著增加患者血脂达标率、降低hs-CRP水平,改善患者临床转归.%Objective To study the effect of high rosuvastatin dose on outcome in patients with large artery atherosclerotic stroke (LAAS).Methods Eighty-two LAAS patients were randomly divided into high rosuvastatin dose group (n=39) and routine rosuvastatin dose group (n=43).Their serum blood lipid level and inflammatory indexes were measured and their clinical outcome was assessed.Results No significant difference was found in mortality,recurrence and hemorrhagic transformation between the two groups (P＞0.05).The rate of improved outcome was significantly higher in high rosuvastatin dose group than in routine rosuvastatin dose group (84.62％ vs 65.12％,P=0.04).The serum hs-CRP level was significantly lower in routine rosuvastatin dose group and high rosuvastatin dose group after treatment than before treatment (0.56±0.60 mg/L vs 0.70±0.68 mg/L,P=0.01;0.22±0.29 mg/L vs 0.69±0.58mg/L,P=0.00) and in high rosuvastatin dose group than in routine rosuvastatin dose group after treatment than before treatment (0.22±0.29 mg/L vs 0.56±0.60 mg/L,P=0.00).The rate of LDL C＜1.8 mmol/L and non HDL-C＜2.6 mmol/L was significantly higher in high rosuvastatin dose group than in rosuvastatin dose group after treatment (69.23％ vs 46.51％,P=0.04;66.67％ vs 41.86％,P=0.03).No significant adverse reactions occurred in both groups.Conclusion High rosuvastatin dose can effectively increase the blood lipid level,reduce the serum hs-CRP level,and improve the clinical outcome in LAAS patients.
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