| 杨勇,刘红梅.强化他汀治疗对老年脑出血患者脑出血复发及缺血性血管事件的影响[J].老年医学与保健,2026,32(3):419-423 |
| 强化他汀治疗对老年脑出血患者脑出血复发及缺血性血管事件的影响 |
| Effects of intensive statin therapy on recurrence of cerebral hemorrhage and ischemic vascular events in elderly patients with cerebral hemorrhage after treatment |
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| DOI：10.3969/j.issn.1008-8296.2026.03.017 |
| 中文关键词: 老年 脑出血 瑞舒伐他汀强化治疗 血脂 炎症因子 复发 缺血性血管事件 |
| 英文关键词: elderly cerebral hemorrhage intensive Rosuvastatin therapy blood lipid inflammatory factor recurrence ischemic vascular event |
| 基金项目:QKY2023-33:长三角数字干线青浦区科技发展基金项目 |
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| 中文摘要: |
| 目的 观察强化他汀治疗对老年脑出血治疗后患者脑出血复发及缺血性血管事件的影响.方法 回顾性选取2023 年3 月至2024 年3 月上海市青浦区中医医院接受诊疗的144 例老年脑出血后患者的临床资料,根据是否采用强化他汀治疗分为对照组(n=71)和观察组(n=73).2 组患者均按照指南行常规对症支持治疗,并于稳定期开始规律服用瑞舒伐他汀;对照组患者予10 mg/d 瑞舒伐他汀长程治疗;观察组患者于前3 个月予20 mg/d,之后改为10 mg/d 瑞舒伐他汀长程治疗;2 组均进行为期 1 年的随访.比较 2 组患者炎性因子指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、C 反应蛋白(CRP)]、血脂指标[总胆固醇(TC)、低密度脂蛋白(LDL)]以及脑出血复发和缺血性血管事件发生情况.结果 治疗前,2 组患者 TNF-α、IL-1β、CRP、TC、LDL 水平差异无统计学意义(P>0.05);治疗后,2 组患者TNF-α、IL-1β、CRP、TC、LDL 水平均下降,且观察组患者指标均低于对照组[TNF-α:(5.21±2.04)pg/mL比(6.68±2.57)pg/mL;IL-1β:(4.26±1.07)pg/mL 比(4.93±1.24)pg/mL;CRP:(3.84±1.62)mg/mL比(4.61±1.37)mg/mL;TC:(4.06±0.89)mmol/L 比(4.55±0.73)mmol/L;LDL:(1.65±0.57)mmol/比(1.96±0.64)mmol/L,P<0.05].2 组患者脑出血复发率比较差异无统计学意义(P>0.05);观察组患者缺血性血管事件总发生率低于对照组,差异有统计学意义(P<0.05).结论 老年脑出血患者病情稳定后规律强化他汀治疗,能够减轻炎症反应,改善血脂水平,减少短期缺血性血管事件的发生,且未增加老年脑出血的复发风险. |
| 英文摘要: |
| Objective To observe the effects of intensive statin therapy on recurrence of cerebral hemorrhage and ischemic vascular events in elderly patients with cerebral hemorrhage after treatment.Methods The clinical data of 144 elderly patients with cerebral hemorrhage who were diagnosed and treated in Qingpu District Hospital of Traditional Chinese Medicine in Shanghai from March 2023 to March 2024 were retrospectively selected.Patients were divided into control group(n=71)and observation group(n=73)based on whether they received intensive statin therapy.Both groups received conventional symptomatic and supportive treatment according to clinical guidelines and started regular rosuvastatin treatment during the stable phase.The control group received 10 mg rosuvastatin for long-term treatment,while the observation group received 20 mg for 3 months followed by 10 mg for long-term treatment.Both groups were followed up for 1 year.Inflammatory factor levels[tumor necrosis factor-alpha(TNF-α),interleukin-1β(IL-1β),C-reactive protein(CRP)],lipid levels[total cholesterol(TC),low-density lipoprotein(LDL)],as well as the occurrence of cerebral hemorrhage recurrence and ischemic vascular events were compared between the two groups.Results Before treatment,there were no statistically significant differences in the levels of TNF-α,IL-1β,CRP,TC and LDL between the two groups(P>0.05).After treatment,the levels of TNF-α,IL-1β,CRP,TC and LDL decreased in both groups,and the observation group was lower than the control group[TNF-α:(5.21±2.04)pg/mL vs(6.68±2.57)pg/mL;IL-1β:(4.26±1.07)pg/mL vs.(4.93±1.24)pg/mL;CRP:(3.84±1.62)mg/mL vs.(4.61±1.37)mg/mL;TC:(4.06±0.89)mmol/L vs.(4.55±0.73)mmol/L;LDL:(1.65±0.57)mmol/vs.(1.96±0.64)mmol/L,P<0.05].There was no statistically significant difference in the incidence of cerebral hemorrhage recurrence between the two groups(P>0.05),but the total incidence of ischemic vascular events in the observation group was lower than that in the control group,with a statistically significant difference(P<0.05).Conclusion After the condition of elderly patients with cerebral hemorrhage stabilizes,regular intensive statin treatment can significantly reduce inflammatory responses,improve blood lipid levels,and decrease the occurrence of short-term ischemic vascular events.This study did not find that intensive statin therapy significantly increases the risk of cerebral hemorrhage recurrence in elderly patients. |
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