目的 比較分析不同劑量阿托伐他汀鈣對腦梗死患者血清炎癥因子及頸動脈斑塊的影響。方法 選擇2014年1月-2015年6月在西安市第四醫(yī)院接受治療的178例腦梗死患者，根據(jù)用藥劑量的不同分為低劑量組90例和高劑量組88例。低劑量組患者在基礎治療上，給予阿托伐他汀鈣10 mg/d治療；高劑量組也給予患者阿托伐他汀鈣20 mg/d治療，所有患者均給予6個月治療。比較分析兩組患者治療前后的血脂水平，包括總膽固醇（TC）、低密度脂蛋白膽固醇（LDL-C）、高密度脂蛋白膽固醇（HDL-C）、三酰甘油（TG）；血清炎癥因子水平，包括高敏C-反應蛋白（hs-CRP）、血漿白細胞介素6（Interleukin-6，IL-6）、腫瘤壞死因子（TNF-α），以及頸動脈粥樣硬化斑塊指標的變化情況。結果 治療6個月后，所有患者的血脂水平較治療前均有顯著性改善，差異有統(tǒng)計學意義（P<0.05）；且高劑量組的血脂水平顯著優(yōu)于低劑量組，差異有統(tǒng)計學意義（P<0.05）。所有患者的血清炎癥因子水平較治療前均有顯著性改善，差異有統(tǒng)計學意義（P<0.05）；且高劑量組的血清炎癥因子水平顯著低于低劑量組，差異有統(tǒng)計學意義（P<0.05）。此外，低劑量組動脈粥樣硬化指標較治療前無明顯改善，但高劑量組較治療前有明顯降低，且顯著低于低劑量組，比較差異有統(tǒng)計學意義（P<0.05）。結論 阿托伐他汀鈣有助于改善腦梗死患者的血脂水平、血清炎癥因子以及頸動脈粥樣硬化斑塊，而20 mg/d給藥劑量臨床效果更為明顯。

Objective To investigate the effect of atorvastatin calcium with different doses on inflammatory cytokine and carotid atherosclerotic plaque of patients with cerebral infarction. Methods One hundred and seventy-eight patients with cerebral infarction admitted into our hospital from January 2014 to June 2015 were divided into low dose (LD) group and high dose (HD) group. Ninety patients in LD group were treated with atorvastatin calcium in a dose of 10 mg/d, and eighty-seven patients in HD group were treated with atorvastatin calcium in a dose of 20 mg/d. The serum levels of lipid including TC, TG, LDL-C, HDL-C, inflammatory cytokine including hs-CRP, IL-6, TNF-α, and carotid atherosclerotic plaque of both groups were analyzed and compared before and after treatment. Results After six months of treatment, the serum levels and inflammatory cytokine of patients in both groups showed remarkable improvement (P<0.05), and those in HD group were significantly better than those of LD group (P<0.05). Additionally, compared with those before treatment, changes in carotid atherosclerotic plaque of patients in LD group were not obvious, while those in HD group markedly decreased, and which were significantly lower than those of LD group (P<0.05). Conclusion Atorvastatin calcium with HD of 20 mg/d showed a better capability on improving serum levels of lipid, inflammatory cytokine, and carotid atherosclerotic plaque of patients with cerebral infarction than those with LD of 10 mg/d.