目的：分析瑞舒伐他汀、辛伐他汀及阿托伐他汀三种降血脂药物应用于老年动脉粥样硬化性急性脑梗死合并高血脂患者的临床效果差异。方法选取2014年2月~2015年2月石家庄市第三医院神经内科收治的180例老年动脉粥样硬化性急性脑梗死合并高血脂患者，患者起病后24 h内入院。根据就诊顺序随机分为瑞舒伐他汀组、辛伐他汀组及阿托伐他汀组，各60例。在常规治疗基础上，瑞舒伐他汀组口服瑞舒伐他汀片，辛伐他汀组口服辛伐他汀片，阿托伐他汀组口服阿托伐他汀片，三组患者共接受2周治疗。检测治疗前后三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、血清C反应蛋白（CRP）、白介素-6（IL-6）、肿瘤坏死因子-ɑ（TNF-ɑ）、血清肌酸激酶（CK）、谷丙转氨酶（ALT）、谷草转氨酶（AST）水平及美国国立卫生研究院卒中量表（NIHS）评分。结果治疗2周后，三组患者的TG、TC、HDL-C、LDL-C、CRP、IL-6、TNF-ɑ水平较本组入院时均显著的改善（P＜0.05），瑞舒伐他汀患者的TG、TC、LDL-C、CRP、IL-6、TNF-ɑ水平显著的低于辛伐他汀组及阿托伐他汀组、HDL-C水平显著的高于辛伐他汀组及阿托伐他汀组（P＜0.05）；阿托伐他汀组患者的CRP、TNF-ɑ水平显著的低于辛伐他汀组患者（P＜0.05）。治疗1个月后，三组患者的 NIHSS评分较入院时均显著的降低（P＜0.05），瑞舒伐他汀组患者的NIHSS评分显著的低于辛伐他汀组及阿托伐他汀组（P＜0.05）。结论瑞舒伐他汀、辛伐他汀及阿托伐他汀均具有较好的降血脂效果，安全性均较高，但是瑞舒伐他汀具有更好的改善患者急性期炎症反应，同时降血脂效果及改善患者神经功能缺损症状更显著的优势。%Objective To study and analysis of the clinical effect of three kinds of lowering lipid-lowering drugs, which were used in the elderly patients with acute cerebral infarction and high blood fat.Methods 180 patients with senile atherosclerotic acute cerebral infarction and high cholesterol, and treated in neurology department of the Third Hospital of Shijiazhuang between 2014.02~2015.02 were selected. Patients were randomly divided into rosuvastatin group, simvastatin group and atorvastatin group. Each group has 60 patients. Besides regular treatment, rosuvastatin group was given rosuvastatin, simvastatin group was given simvastatin and atorvastatin group was given atorvastatin. The treatment maintained for 2 weeks. Triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), serum C reactive protein (CRP) and interleukin 6 (IL-6), tumor necrosis factor - alpha (TNF alpha), serum creatine kinase (CK), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and National Institutes of Health Stroke Scale (NIHSS) were test before and after treatment.Results After 2 weeks of treatment, TG, TC, HDL-C, LDL-C, CRP, IL-6, TNF-ɑ levels in all patients were significantly improved than the time of admission (P<0.05). TG, TC, LDL-C, CRP, IL-6 and TNF-ɑ in rosuvastatin group was significantly lower, and HDL-C levels was significantly higher than other two groups. CRP, TNF-ɑ in atorvastatin group was significantly lower than simvastatin group (P<0.05). NIHSS score was significantly reduced in all patients at one month after treatment (P<0.05). NIHSS scores in rosuvastatin group were significantly lower than the simvastatin group and atorvastatin group (P<0.05). Conclusion Rosuvastatin, simvastatin and atorvastatin were safety and have good lipid-lowering effect. But rosuvastatin is better than other two drugs in acute phase inflammatory response and neurological deficit symptoms improvement, as well as lipid-lowering effect.
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