目的：探讨不同剂量阿托伐他汀对急性脑梗死的抗炎效果及对动脉粥样硬化斑块稳定性的影响。方法：选取2013年6月—2015年6月江门市人民医院收治的急性脑梗死患者102例作为研究对象。将患者以抽签法随机分为A、B、C 3组，每组各34例。 A组患者给予阿托伐他汀10 mg，B组患者给予阿托伐他汀20 mg，C组患者给予阿托伐他汀40 mg，1日1次。比较治疗前后3组患者超敏C反应蛋白（hs-CRP）、基质金属蛋白酶9（MMP-9）、白细胞介素6（IL-6）、白细胞介素17（IL-17）水平，以及颈动脉内-中膜厚度（ IMT）和颈动脉粥样硬化斑块面积变化情况，同时观察不良反应发生情况。结果：治疗后，C组患者hs-CRP、MMP-9、IL-6、IL-17水平均显著低于A、B组，差异均有统计学意义（P＜0.05）；治疗后，C组患者IMT和颈动脉粥样硬化斑块面积显著低于治疗前，且显著低于A、B组治疗后，差异均有统计学意义（P＜0.05）；3组患者不良反应发生率的差异无统计学意义（P＞0.05）。结论：大剂量阿托伐他汀治疗急性脑梗死，可显著降低炎性因子表达，稳定动脉粥样硬化斑块，无严重不良反应。%OBJECTIVE:To probe into the effects of different doses of atorvastatin on anti-inflammatory effects and atherosclerotic plaque stability of acute cerebral infarction .METHODS: 102 patients with acute cerebral infarction admitted into Jiangmen People's Hospital from Jun .2013 to Jun .2015 were selected to be divided into group A , group B and group C via the lot drawing method , with 34 cases in each .Group A were given 10 mg atorvastatin , group B were treated with 20 mg atorvastatin and group C received 40 mg atorvastatin, qd.Changes of hs-CRP, MMP-9, IL-6, IL-17 were compared among three groups before and after treatment , changes of IMT and carotid atherosclerotic plaque area, incidence of adverse drug reactions of three groups were observed .RESULTS:After treatment, hs-CRP, MMP-9, IL-6, IL-17 levels of group C were significantly lower than those of group A and group B , with statistically significant difference ( P 0.05 ) .CONCLUSIONS: High doses of atorvastatin in treatment of acute cerebral infarction can effectively reduce the expression of inflammatory cytokines and stable the effects of atherosclerotic plaque without any severe adverse drug reactions .
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