Different Doses Of Atorvastatin Affect On Recent Prognosis In Patients With Acute Cerebral Infarction

ObjectiveTo observe the different doses of atorvastatin calcium affect on recent prognosis of the patients with atherosclerosis cerebral infarction and affect on the blood viscosity, the D-dimer, the homocysteine,the biochemistry,the white blood cells, the high-sensitivity C-reactive protein, the intima-media thickness of the internal carotid artery. Thereby the aim of the study is to investigate the pleiotropic and the safety of atorvastatin calcium in the treatment of the patients with acute cerebral infarction.Methods:According to TOAST classification, CT, MRI, Carotid ultrasound, ECQ and so on,the patients with atherosclerosis cerebral infarction was Selected.According to inclusion and exclusion criteria,we excluded the cases that did not meet the criteria, and that the information was incompleted. Ninety-six patients who were in line with the standard and were onset within3-48h, were randomly divided into three groups:the10mg group, the20mg group, the40mg group. Finally the study investigated90patients for90days. The blood viscosity, the D-dimer, the homocysteine, the creatine kinase,the biochemistry, the white blood cells, the high-sensitivity C-reactive protein, the intima-media thickness of the internal carotid artery, and the NHISS were compared,before and after treatment. At the same time,the side effects to drug were recorded.Results:(1) From the age, the sex, the history of diabetes, the hypertension, the smoking, the alcohol consumption, to the history of the family disease, the three groups were no significant differences. Before treatment, there were no difference in the laboratory indexs, IMT, NHISS and so on (P>0.05).(2) Atorvastatin on lipid composition:after treatment, the LDL-C of each group decreased significantly, after90days treatment, the LDL-C of each group decreased more than50%(33.3%,53.3%,56.7%respectively). Compared with the20mg and40mg groups, the LDL-C levels of the10mg group was high,the differences were statistically significant (P<0.05). Compared with the40mg group, that of the20mg group was high,the differences were no statistically significant (P>0.05).TC decreased significantly in each group after treatment,the baseline decreased(1.46,1.62,1.90respectively).Compared with the20mg and40mg groups, the TC of the10mg group was high,the differences were statistically significant (P<0.05). Compared with the40mg group, the TC of the20mg group was high, the differences were no statistically significant (P>0.05).HDL in each group was much higher at30days,and to90days, it increased further. There were the differences among the groups,the differences were statistically significant (P <0.05).TG among each group decreased significantly after the treatment of30days and90days. TG in each group was not different after90days treatment,the differences were no statistically significant (P>0.05).(3) the effect of atorvastatin to NHISS:after treatment,NIHSS score of each group was decreased,the differences were statistically significant. Compared with the20mg and40mg groups,the mRS score of the10mg group was low(P<0.05), prognosis of the10mg group was bad after90days treatment(P<0.05)(4) coagulation function:after90days treatment, the DD of each group decreased significantly. Compared with the10mg and20mg groups, the DD of the40mg group decreased,the differences were statistically significant (P<0.05). Compared with the10mg group, the DD of the20mg group was not different,the differences were not statistically significant (P>0.05). the Fi and the BV of each group decreased after90days treatment, the differences were no statistically significant (P>0.05).(5) The Side effects:there were no patient whose CK increased two times higher than the upper limit of normal and whose liver enzymes increased two times higher than the upper limit of normal.There was no new diabetes patient in each group.(6) IMT:IMT in each group decreased after treatment, the differences were no statistically significant (P>0.05).Patients in each group had no intimal thickening.(7) effect of Anti-inflammatory:after30days treatment,compared with the20mg group and40mg group, the HsCRP of the10mg group was high, the differences were statistically significant (P<0.05). Compared with the40mg group, that of the20mg group was high,the differences were no statistically significant (P>0.05).There were no differences of HsCRP among the three groups after90days treatment(P>0.05).Conclusions:(1) Atorvastatin was good at lipid metabolism in the patients with atherosclerosis cerebral infarctionC Lower LDL,TC; TG; elevated HDL), And there is a dose-dependent manner。(2) atorvastatin might improve functional outcome of the patients with atherosclerosis cerebral infarction after90days treatment.(3) Atorvastatin had an advatage of anti-atherogenic, anti-inflammatory, anticoagulant effect.(4) It is necessary and safe to using atorvastatin in the acute phase.(5)20mg dose can produce better economic benefits in this study. Atorvastatin20mg dose groups have better economic benefits of the drug in this study. This dose of atorvastatin therapy may be the most appropriate for most people with atherosclerotic cerebral infarction Chinese population.