Abstract:Objective To investigate the effects of intensive statin intervention on lipid profile improvement and plaque stability in patients with cerebral atherosclerosis（CAS），and to provide references for clinical treatment. Methods A total of 103 patients with CAS treated at Xinyang People's Hospital from January 2023 to May 2024 were selected and randomly divided into a study group（n=52）and a basic group（n=51）using a random number table method. After basic treatment，the basic group received low-dose atorvastatin calcium（10 mg/d），while the study group received high-dose atorvastatin calcium（40 mg/d for 14 days followed by 20 mg/d thereafter），all of which continued for 6 months. The two groups were compared before and after treatment in terms of lipid levels［total cholesterol（TC），triglycerides（TG），high-density lipoprotein cholesterol（HDL-C），low-density lipoprotein cholesterol（LDL-C）］，plaque parameters［carotid intima - media thickness（IMT），carotid plaque area］，hemodynamic parameters［resistance index（RI），pulsatility index（PI），systolic flow velocity（Vs），diastolic flow velocity（Vd）］，and inflammatory factor levels［tumor necrosis factor-alpha（TNF-α），high-sensitivity C-reactive protein（hs-CRP），interleukin-1（IL-1）］. Results After treatment，TC，TG，HDL-C，LDL-C，RI，PI，Vs，Vd，TNF-α，hs-CRP，and IL-1 improved in both groups compared with before treatment，and the magnitude of change was greater in the study group than in the basic group（P<0.05）. After treatment，the carotid plaque area in both groups decreased slightly compared to before treatment，with no statistically significant differences（P>0.05）. The study group showed lower post-treatment IMT than pre-treatment（t=5.294，P<0.001）and the basic group（t=2.521, P=0.013）. Conclusion High - dose atorvastatin calcium treatment for CAS can not only improve lipid profiles，reduce the IMT，but also regulate hemodynamic parameters and reduce inflammatory responses.The adverse reactions to intensive doses need further observation.