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  • 1 Pécsi Tudományegyetem, Általános Orvostudományi Kar Neurológiai Klinika Pécs Rét u. 2. 7623
  • 2 Pécsi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Pécs
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Cerebrovascularis betegekben gyakoriak a haemorrheologiai és haemostaseologiai paraméterek kóros eltérései. A statinok az ischaemiás stroke prevenciójában hatékonyan alkalmazható szerek, kedvező hatásuk hátterében a lipidszint csökkentése mellett egyéb tényezők is igazolhatók. Célok: Tanulmányukban a szerzők áttekintik az atorvastatin stroke-prevencióval, haemorrheologiai és haemostaseologiai hatásaival kapcsolatos irodalmi adatokat, hivatkozva egy korábbi vizsgálatuk eredményeire, mely kis dózisú atorvastatinkezelés rövid távú haemorrheologiai, valamint endothel-diszfunkcióra és a thrombocytaaggregációra gyakorolt effektusait vizsgálta. Módszerek: 27 krónikus, hyperlipidaemiás agyérbetegnél (átlagéletkor: 61 ± 8 év) meghatározták a szérumlipidszinteket, a haemorrheologiai paramétereket (haematocrit, plazmafibrinogén-koncentráció, plazma- és teljesvér-viszkozitás, vörösvértest-aggregáció és -deformabilitás), a thrombocytaaggregációt kiinduláskor, majd 1 és 3 hónappal napi 10 mg atorvastatinkezelést követően. Az endothel-diszfunkciót jelző von Willebrand-faktor aktivitását a kezelés előtt, majd 1 hónap múlva mérték meg. Eredmények: A plazmakoleszterin-szint átlagos csökkenése 1, illetve 3 hónap múlva egyaránt 28% volt ( p < 0,001), az LDL-koleszterin-szint 40%-kal, illetve 38%-kal ( p < 0,001) csökkent a kiindulási értékhez képest. Az atorvastatinkezelés a teljesvér-viszkozitást a 3. hónap végére, míg a vvt-deformabilitást már az első hónap végére szignifikánsan csökkentette ( p < 0,05). A kollagén indukálta thrombocytaaggregáció a kiindulási értékhez képest szignifikánsan csökkent ( p < 0,001) változatlan antiaggregációs kezelés mellett. Szintén szignifikánsan javult a von Willebrand-faktor-aktivitás már 1 hónapos kezelést követően ( p < 0,05). Következtetések: Mind az irodalmi, mind a szerzők saját eredményei az atorvastatin komplex, kedvező hatására utalnak. A lipidcsökkentő effektus mellett a kis dózisban és rövid ideig alkalmazott atorvastatin javítja a haemorrheologiai paramétereket, a thrombocytaaggregációt és az endothel-diszfunkciót.

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