氯吡格雷联合瑞舒伐他汀对急性脑梗死患者血清炎性因子的影响

Effect of clopidogrel combined with rosuvastatin on inflammatory factors of patients with acute cerebral infarction

目的研究氯吡格雷联合瑞舒伐他汀对急性脑梗死患者血清炎性因子的影响。方法选取就诊的急性脑梗死患者177例,随机分为对照组(88例)和观察组(89例),两组均采取降压、纠正酸碱和水电解质紊乱等常规治疗,在此基础上对照组给予瑞舒伐他汀20 mg/次,1次/d,观察组给予瑞舒伐他汀20 mg/次,1次/d与氯吡格雷75 mg/次,1次/d。比较两组在治疗前与治疗后患者血清中高敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、凝血因子I(FIB)的浓度及S100β蛋白的浓度变化。结果两组患者治疗7 d后,血清中hs-CRP、IL-6、IL-1β、TNF-α、FIB浓度明显低于治疗前,而IL-10浓度明显高于治疗前;而与对照组相比较,观察组患者血清中hs-CRP、IL-6、IL-1β、TNF-α、FIB浓度显著降低,IL-10浓度显著升高。在治疗7 d后,两组患者血清中S100β蛋白浓度明显低于治疗前,而与对照组相比较,观察组患者血清中S100β蛋白浓度浓度显著降低。结论在急性脑梗死患者治疗中联合应用氯吡格雷与瑞舒伐他汀疗效优于单用瑞舒伐他汀,可通过下调促炎因子,上调抗炎因子抑制炎性反应,减轻神经细胞损伤。

Objective To investigate the effect of clopidogrel combined with rosuvastatin on inflammatory factors of patients with acute cerebral infarction.Methods Totally 117 patients with acute cerebral infarction were selected from September 2016 to October 2018 at the First Affiliated Hospital of Xinxiang Medical University and randomly divided into control group(88 cases)and observation group(89 cases).Both groups of patients were routinely treated for hypotension,acid and alkali disorders and water electrolyte disorders.The patients in the control group were treated with rosuvastatin for 14 consecutive days.The patients in the observation group were treated with rosuvastatin plus clopidogrel for 14 consecutive days.Serum concentrations of hs-RP,IL-6,IL-1β,TNF-α,FIB and S100βprotein were measured and analyzed before and after treatment.Results Seven days after treatment in two groups,the concentrations of hs-RP,IL-6,IL-1β,TNF-α,and FIB in serum were significantly lower than those before treatment,while the concentration of IL-10 was significantly higher than before treatment.Compared with the control group,the concentrations of hs-RP,IL-6,IL-1β,TNF-α,FIB in serum were significantly reduced and the concentration of IL-10 in serum was significantly increased in observation group.After treatment in two groups,the concentration of S100βprotein in serum was significantly lower than that before treatment.Compared with the control group,the concentration of S100βprotein in serum was significantly lower in observation group.Conclusion The combined effect of clopidogrel and rischvastatin on the treatment of acute cerebral infarction is better than that of rischvastatin alone.They can reduce inflammatory factors and increase anti-inflammatory factors to inhibit inflammatory reactions and reduce nerve cell damage.