急性脑梗死患者氧化低密度脂蛋白和可溶性细胞黏附因子1对阿伐他汀钙干预的反应

Effects of atorvastatin calcium on oxidative low density lipoprotein and soluble intercellular adhesion molecule-1 in patients with acute cerebral infarction

目的:氧化低密度脂蛋白和可溶性细胞黏附因子1均参与动脉粥样硬化过程,观察急性脑梗死患者应用他汀类降脂药阿伐他汀钙后体内两种因子水平的变化。方法:将佳木斯大学第一附属医院2002-02/2003-12收治的76例急性脑梗死患者随机分成阿伐他汀钙组及对照组两组,每组38例。两组常规治疗(溶栓、抗凝、钙通道阻断药、脑保护剂、活血化淤类药物等)相同,在此基础上,阿伐他汀钙组加用阿伐他汀钙10mg口服,1次/d,连续服用12周。治疗前及治疗12周后采用夹心酶联免疫吸附法测定血浆可溶性细胞黏附因子1和氧化低密度脂蛋白水平,同时观察血脂的变化。结果:按实际处理分析,72例患者进入结果分析。①可溶性细胞黏附因子1水平:阿伐他汀钙组治疗后较治疗前显著降低,且低于对照组治疗后犤(181.43±16.76),(331.56±52.41),(311.45±47.68)μg/L,P<0.01犦。②氧化低密度脂蛋白浓度:阿伐他汀钙组治疗后较治疗前显著降低,且低于对照组治疗后犤(49.21±6.1),(72.34±5.38),(67.28±5.08)mmol/L,P<0.05犦。③血脂变化:阿伐他汀钙组治疗后胆固醇、三酰甘油和高、低密度脂蛋白胆固醇均较治疗前明显改善(P<0.05),而对照组治疗前后无差异(P>0.05)。结论:阿伐他汀钙能降低脑梗死患者体内氧化低密度脂蛋白和可溶性细胞黏附因子1水平,通过影响黏附因子的表达及行为,减少神经损伤。

AIM： Oxidative low density lipoprotein （oxLDL） and soluble intercelluar adhesion molecues-1 （sICAM-1） take part in the process of atherosclerosis： We studied the effects of atorvastatin calcium on the changes of two kinds of factors in patients with acute cerebral infarction. METHODS： Seventy-six patients with acute cerebral infarction from First Affiliated Hospital of Jiamusi University from February 2002 to December 2003 were selected and divided randomly into atorvastatin calcium group and control group with 38 in every group. Routine treatment was performed in the two groups （including thrombolysis, anticoagulant, brain protectant and sitimulated blood dissolved silt drugs,etc,）. On this basis, peroral atorvastatin calcium 10 mg was taken in atorvastatin calcium group once per day for 12 weeks, Enzyme-linked immunosorbent assay was used to measure the plasma sICAM-1 and oxLDL 12 weeks before and after therapy in the two groups. RESULTS： Seventy-two patients were involved in the results analysis according to practical treat analysis. ① Level of sICAM-1： It was significantly decreased in atorvastatin calcium group after treatment, and lower than that in control group [（181.43±16.76）, （331.56±52.41 ）, （311.45±47.68）μg/L, P〈 0.01], ② Concentration of oxide low density lipoprotein： It was significandy decreased in atorvastatin calcium group after treatment, and lower than that in control group [（49.21±6.1）, （ 72.34±5.38 ）, （67.28±5.08） mmol/L, P 〈 0.05]. ③ Changes of blood-lipid： Cholesterol, tfiacylglycerol and high-low density lipoprotein cholesterol were improved significantly in atorvastatin calcium group （P 〈 0.05）, and it had insignificant changes in controlled group （P 〉 0.05）. CONCLUSION： The level of oxLDL and sICAM-1 are reduced by atorvastatin calcium. Nerve injury decreases through affecting the expression and behavior of adhesion factors.