Study On The Efficacy And Safety Of Intensive Statin In Patients With Ischemic Cerebrovascular Disease Treated By Interventional Therapy

Objectives: To study the efficacy and safety of atorvastatin at enhanced dose in interventional patients with ischemic cerebrovascular disease,and to provide scientific basis for clinical rational drug use.Methods:76 patients with ischemic cerebrovascular disease who underwent interventional therapy in the First Affiliated Hospital of Xinjiang Medical University from September 2016 to September 2018 were randomly divided into two groups: group A: statin conventional treatment group(38 cases).Atorvastatin calcium tablets were given 20 mg/day 1 week before surgery,and the same dose was continued after operation.Group B: statin intensive treatment group(38 cases),atorvastatin calcium tablets 40 mg/day were given 1 week before surgery.Continue to take the same dose after surgery.The general baseline data of the two groups: age,gender,smoking history,hypertension,diabetes,preoperative blood lipids,liver enzymes,muscle enzymes,etc.,no statistical differences,comparable.Both groups were followed up for 6 months.Blood was taken 1 day and 6 months after surgery.Observed between the two groups:(1)hematological indicators: 1 inflammation index: hypersensitive C-reactive protein(hs-CRP).2 blood lipid levels: total cholesterol(Total Chlesterol,TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein(High-destiny lipoprotein cholesterol,HDL-C).3 liver enzymes: Aspartate amino transferase(AST),alanine aminotransferase(ALT).4 muscle enzyme: creatine kinase(Ceatine kinase CK)and the like.(2)incidence of in-stent restenosis(ISR).(3)adverse cardiovascular and cerebrovascular events: new infarction,transient cerebral ischemic attack(TIA),cerebral hemorrhage,myocardial infarction,etc.in the blood supply area of the diseased blood vessel.(4)Improvement of neurological function: The number of people with mRS score ≤ 2 points.(5)Drug safety: AST/ALT continued to increase ≥ 3 times,CK continued to increase ≥ 10 times,myalgia,muscle dissolution and so on.Results:(1)There was no difference in baseline lipid data(P>0.05).At 6 months follow-up,TC,TG,LDL-C levels decreased compared with preoperative,and HDL-C levels increased compared with preoperative,respectively.There was a statistical difference(P<0.05).There was no statistical difference in hs-CRP between the two groups(P>0.05).The hs-CRP was significantly higher than that before surgery,and there were statistical differences in the group(P<0.05).Comparison between groups: the increase in the conventional group was more significant(P<0.05);the decrease was significantly lower at 6 months than at 1 day after surgery,and the decrease was more significant in the enhanced group(P<0.05).(2)In-stent restenosis: At the 6-month follow-up,there was no≥50% reduction in the diameter of the stent lumen,and 1 lumen reduction was 20-50% in each case,and 4 lumen diameter reduction in the conventional group.10-20%,there was no statistical difference between the two groups(P>0.05).(3)Adverse cardiovascular and cerebrovascular events: In the conventional treatment group,there were 3 cases of newly-infected lesions in the blood supply area at 6 months after operation,5 cases of TIA,no cerebral hemorrhage and myocardial infarction.In the intensive treatment group,1 case of newly diagnosed lesions in the infarction of the donor area,1 cases of TIA,no cerebral hemorrhage,myocardial infarction.There were statistical differences between the two groups in total adverse cardiovascular and cerebrovascular events(P<0.05).(4)Improvement of neurological function: There was no difference in the number of patients with preoperative mRS score≤2 points.The number of patients with mRS score ≤ 2 points in the intensive group at 6 months was higher than that in the conventional group,and there were statistical differences(P<0.05).(5)Drug safety: no increase in liver enzymes(AST and ALT)≥3 times,Creatine kinase(CK)continued to increase≥10 times,myalgia and muscle dissolution,etc.,safety comparison There was no statistical difference(P>0.05).Conclusions: 1.Intensive statin therapy can significantly improve the neurological prognosis of patients with ischemic cerebrovascular disease.2.Intensive statin therapy can reduce the vascular inflammatory response after interventional therapy in patients with ischemic cerebrovascular disease,and has a tendency to reduce the incidence of ISR.3.Intensive statin treatment can significantly reduce the levels of blood TC,TG,LDL-C in patients with ischemic cerebrovascular disease after interventional therapy,and increase blood HDL-C levels,and has a good safety.