摘要
目的观察脑梗死急性期阿托伐他汀的抗炎作用。方法131例脑梗死急性期患者随机分为3组,A组为普通治疗组(47例),B组每晚加服阿托伐他汀10mg(42例),C组每晚加服阿托伐他汀20mg(42例),均治疗14d。观察治疗前、治疗后7d、治疗后14d高敏C反应蛋白(hsCRP)、白细胞介素6(IL-6)的变化,比较治疗前、治疗14d后血脂、神经功能缺损评分、生化指标等变化,并调查发病6个月的生存状态。结果(1)各组治疗后hsCRP均有下降,A组、B组、C组hsCRP在治疗后7d分别降低9·1%、33·9%、33·5%,14d分别降低34·3%、56·0%、56·8%,B、C组hsCRP下降百分率较A组明显,差异均有统计学意义(均P<0·05)。(2)治疗7d后,A组、B组、C组IL-6分别下降44·2%、50·8%、49·2%,14d后分别下降48·0%,51·6%、51·4%,下降百分率差异无统计学意义(均P>0·05)。(3)B组hsCRP的降低与总胆固醇下降百分数间无相关关系(r=0·141,P=0·373),与低密度脂蛋白胆固醇(LDL-C)下降百分数间亦无相关关系(r=0·027,P=0·866)。C组hsCRP的降低与总胆固醇、LDL-C下降百分数间也无相关关系(分别为r=0·126,P=0·427;r=0·069,P=0·662)。(4)对神经功能缺损评分,6个月预后无明显影响。结论阿托伐他汀在脑梗死急性期应用,具有不依赖降脂的抗炎作用,有利于减轻脑梗死急性期继发的炎症损伤。
Objective To observe the effects of different doses of atorvastatin on the plasma hypersensitive C-reactive protein （hsCRP） and interleukin-6 （IL-6） in patients with acute cerebral infarction. Methods 131 patients with acute cerebral infarction, 73 males and 58 females, aged 63 ~ 11, were randomly divided into 3 groups ： Group A （ n = 47 ）, with basal treatment ; Group B （ n = 42 ）, atorvastatin 10 mg was added every night; and Group C （n =42）, atorvastatin 20 mg was added every night. Before the treatment and 7 and ld days after the treatment the plasma levels of hsCRP and IL-6, fasting plasma levels of lipid, such as total cholesterol （TC） and low density lipoprotein-C （LDL-C）, liver functions, such as aspartate aminotransferase （ALT） and alanine transaminase （ ALT）, creatine kinase （CK）, urea nitrogen, were detected. Neurological function deficit was determined. The survival condition was surveyed 6 months after. Results （ 1 ） The TC and LDL-C decreased after treatment in the 3 groups with significant differences between Group A and Group C, Group B and Group C, and Group B and Group C （all P 〈 0.05 ）. （2） The plasma level of hsCRP decreased by 9.1% , 33.9% , and 30.1% respectively 7 days after treatment in Groups A, B, and C with significant differences between Groups A and B and between Groups A and C （ both P 〈 0.05 ）, however, without significant difference between Group B and Group C. The level of hsCRP decreased by 34.3% , 56.0% , and 52. 9% respectively 14 days after treatment in the 3 groups with significant differences between Groups A and B and between Groups A and C （both P 〈 0.05 ） , however, without significant difference between Group B and Group C. （3） The level of IL-6 decreased 7 and 14 days after treatment in all 3 groups, however, without significant differences between any 2 groups （ all P 〉 0.05 ）. （4） The decrease of hsCRP and decrease of IL-6 were not correlated with the percentage of TC decrease （ both P 〉 0.05 ） in Group B. The decrease of hsCRP was not correlated with the changes of blood lipids in Group C. （ 5 ） Both the plasma hsCRP and IL-6 before treatment were positively correlated with the infection volume and neurological function score （ all P 〈 0.01 ）. Conclusion Atorvastatin has an anti-inflammatory action benefiting the alleviation of secondary inflammatory damaged in acute cerebral infarction that is independent of lipid lowering.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2005年第40期2841-2845,共5页
National Medical Journal of China
关键词
脑梗死
急相蛋白质类
炎症
Brain infarction
Acute-phase proteins
Inflammation
