关键词:

颅内动脉粥样硬化, 轻型缺血性卒中, 依折麦布, 阿托伐他汀, 预后, 复发

Abstract:

Objective To investigate the efficacy and safety of Ezetimibe combined with Atorvastatin on the short ⁃ term prognosis and recurrence of mild ischemic stroke（MIS）and intracranial atherosclerosis（ICA）. Methods Patients with MIS and ICA who were hospitalized in the Neurology Department of the Second Affiliated Hospital of Nantong University from January 2017 to December 2019 were included and divided into control group and treatment group，the former treated only with Ezetimibe and the latter with Ezetimibe combined with Atorvas⁃ tatin. The Modified Rankin Scale（mRS）was used to evaluate the prognosis of patients in both groups at 90 days. MRS ≤ 2 was regarded as good prognosis and > 2 as poor prognosis. The plaque burden of ICA was assessed by high resolution magnetic resonance vessel wall imaging（HRMR⁃VWI）before and 180 days after treatment in both groups. All the patients were followed up for 12 months after discharge to evaluate the recurrence of ischemic stroke within 12 months. Results A total of 212 patients were included，including 74 in the treatment group and 138 in the control group. There was no significant difference in demographic and baseline data between the two groups （P > 0.05）. There was no significant difference in terms of the short⁃term prognosis of 90 days，while the low⁃ density lipoprotein cholesterol and plaque burden of HRMR⁃VWI were significantly lower 180 days later. One case died of cerebral hemorrhage in the treatment group，and 1 case died of acute coronary syndrome in control group， with no statistical significance in the mortality between the groups（P > 0.05）. There was significant difference in the occurrence rate between the groups（2.7% vs. 12.3%，P < 0.05）. Conclusion Ezetimibe combined with Ator⁃ vastatin is effect in reducing the plaque burden of ICA and the recurrence rate of cerebral infarction within one year in patients with MIS and ICA，and its safety is high.

Key words:

intracranial atherosclerosis, mild ischemic stroke, Ezetimibe, Atorvastatin, progno? sis, recurrence