| Background: Acute cerebral infarction is one of diseases that threaten human being's health. Recent epidemiological data show that cerebral vascular disease has become the leading cause of death in our country.The pathogenesis for cerebral infarction is very complicated, including vascular, cardiogenic, hemodynamic cerebral infarction and other systematic abnormalities, and there is a close relationship between the cause of the disease and the danger factor, prevention and controlling measures and clinical recovery[1-5]. There are some researches on the correlations between relevant factors and different types causes of diseases of patients with acute cerebral infarction at home and abroad now[6], and there are arguments about the intensive cholesterol lowering therapy of patients with acute cerebral infarction. There are insufficient research reports about the influence of intensive cholesterol lowering therapy on different patients with different pathogenesis. There are several methods for classification of ischemic stroke widely used internationally, and Trial of Org 10172 in Acute Stroke Treatment is widely used for its high reliability and validity[7-9]. TOAST is most widely used as methods for classification of pathogenesis because of its being easy to understand and strong practicability. Therefore, the research is to probe the influence of intensive cholesterol lowering therapy on the patients with acute cerebral infarction TOAST subtype.Purpose: Observation of taking effect of intensive lipid-lowering and conventional lipid-lowering on acute cerebral infarction patients etiologic type(toast) subtypes correlated factors and prognosis of intensive lipid-lowering on acute cerebral infarction subtypes according to different subtypes of patients.Method: Using random parallel comparison analysis, choosing 261 patients with acute cerebral infarction as the research objects between January 2014 and June 2014, who were treated by the Neurology of the Second Affiliated Hospital of Nanchang University,. 146 cases were male, 115 cases were female,40 ~ 85 years old, an average of 67.34 + /- 10.67 years old. The research objects were randomly divided into 162-case intensified dose group and 99-case control group. The baseline information of the two groups is of no significant difference. Two groups are formally treated according to the acute cerebral infarction treatment, including improving microcirculation, anti-platelet aggregation, brain protection, controlling blood pressure, controlling blood sugar, preventing complications and limb function exercise therapy. The patients in control group took the oral Rosuvastatin 10 mg/d; Strengthening group took the oral Rosuvastatin 20 mg/d. The two groups of patients were classified According to TOAST standards[10]. The two groups of patients were classified According to TOAST standards, including LAA, CE, SAO,SOE and SUE.Due to the number of SOE and SUE patients were very small, this study will merge the two patients into SUE + SOE type. Monitoring of all patients before and after treatment for 30 days of serum lipids, fasting blood glucose, NIHSS score, the incidence of pulmonary infection within 30 days and 6 months of mortality were compared.Results:(1) Two groups of patients after treatment can improve blood lipid levels, but the enhanced group after treatment, LDL-C, TC levels were significantly lower than the conventional group, the difference was statistically significant(P < 0.05).(2) Two groups of patients toast subtypes of fasting blood glucose after treatment than before treatment significantly decreased, the difference was statistically significant(P < 0.05), but the strengthening group and conventional group the same subtype treatment after fasting blood glucose difference no statistical significance(P > 0.05).;(3) Strengthening group and conventional group the same subtypes after treatment NIHSS score differences were no statistical significance(P > 0.05); and treatment of two groups of patients with various subtypes of 30 days before and after the treatment in the NIHSS score were decreased and intensive group fell more sharply, the difference is statistically significant(P < 0.05).(4) The SAO type of intensive group was lower than that of the conventional group, and the difference was statistically significant(P < 0.05).(5) The mortality rate of the two groups of patients in each of the 6 months after treatment, the difference was not statistically significant. Conclusion:(1) Enhanced lipid lowering serum TC, LDL-C levels decreased more significantly;(2) Intensive dose and conventional dose is beneficial to the control of fasting blood glucose in TOAST patients with acute cerebral infarction;(3) Intensive lipid lowering is beneficial to the prognosis of patients with acute cerebral infarction, and the improvement of neurological function in patients with type CE is more obvious;(4) Intensive lipid lowering can decrease the incidence of SAO in patients with acute cerebral infarction, and the effect of pulmonary infection is more obvious than that of the conventional one, and the effect on the mortality of patients with acute cerebral infarction within 6 months is not significant. |
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