目的 探討阿托伐他汀強(qiáng)化治療急性腦梗死的臨床療效及對血清基質(zhì)金屬蛋白酶-2、3和9的影響。方法 選擇2018年7月-2019年7月上海市楊浦區(qū)市東醫(yī)院收治的急性腦梗死患者84例，隨機(jī)分為常規(guī)組和強(qiáng)化組，每組各42例。常規(guī)組口服阿托伐他汀鈣片20 mg/次，1次/d；強(qiáng)化組口服阿托伐他汀鈣片40 mg/次，1次/d。兩組患者連用4周。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者血清基質(zhì)金屬蛋白酶-2（MMP-2）、MMP-3和MMP-9水平和腦梗死病灶面積。結(jié)果 治療后，常規(guī)組臨床總有效率為78.57%，顯著低于強(qiáng)化組的95.24%。兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組血清MMP-2、MMP-3和MMP-9水平較治療前顯著下降（P<0.05），且強(qiáng)化組下降幅度與常規(guī)組比較更顯著（P<0.05）。治療后，兩組腦梗死病灶面積較治療前顯著縮小（P<0.05），且強(qiáng)化組縮小幅度比常規(guī)組更顯著（P<0.05）。結(jié)論 阿托伐他汀強(qiáng)化治療急性腦梗死患者效果確切，安全性好，減輕血管壁炎癥，抑制細(xì)胞外基質(zhì)及基底膜的降解。

Objective To investigate the curative effect observation of atorvastatin intensive treatment in patients with acute cerebral infarction and the effect on serum MMP-2, MMP-3, and MMP-9. Methods Patients (84 cases) with acute cerebral infarction in Shanghai Yangpu Shidong Hospital from July 2018 to July 2019 were randomly divided into routine and intensive groups, and each group had 42 cases. Patients in the routine group were po with Atorvastatin Calcium Tablets, 20 mg/time, once daily. Patients in the intensive group were po administered with Atorvastatin Calcium Tablets, 40 mg/time, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the serum levels of MMP-2, MMP-3 and MMP-9, the area of cerebral infarction in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the routine group was 78.57%, which was significantly lower than 95.24% in the intensive group, and there were differences between two groups (P<0.05). After treatment, the serum levels of MMP-2, MMP-3, and MMP-9 in two groups were significantly decreased (P<0.05), and which in the intensive group were significantly lower than those in the routine group (P<0.05). After treatment, the area of cerebral infarction in two groups was significantly decreased (P<0.05), and which in the intensive group was significantly smaller than that in the routine group (P<0.05). Conclusions The clinical effect of atorvastatin intensive treatment in patients with acute cerebral infarction is exact and safe, can reduce the inflammation of vascular wall and inhibit the degradation of extracellular matrix and basement membrane.

R971

上海市衛(wèi)生和計(jì)劃生育委員會科研課題計(jì)劃項(xiàng)目（2017450）