苯妥英钠对动脉粥样硬化性脑梗死病人HDL-c、CD62p/CD63的影响

The Influence of Phenytoin Sodium to HDL-c and CD62p/CD63 in Patients after Recent Ischemic Stroke

目的:观察苯妥英钠对动脉粥样硬化性脑梗死病人HDL-c、CD62p/CD63的影响,为动脉粥样硬化性脑血管病的预防提供理论依据。方法:选择门诊或住院动脉粥样硬化的脑血管病病人32例作为治疗组,以苯妥英钠0.2g/d进行治疗,另选择32例相似病例作为对照组,两组病人除苯妥英钠治疗外,其余治疗均相同,治疗前及治疗后30d、90d分别抽取晨空腹血检查HDL-c、CD62p/CD63水平,统计分析治疗前后HDL-c、CD62p/CD63变化百分比评价疗效。结果:治疗组病人在治疗后30d,血清HDL-c水平即开始升高,90d后升高更明显(P<0.01),两组病人血清CD62p阳性的血小板比例在治疗后30d即见明显减少,与治疗前相比均有极显著差异(P<0.01),治疗组与对照组比较差异不明显(P>0.05),治疗90d后进一步减少,治疗90d后治疗组CD62p阳性的血小板比例较对照组下降幅度更明显(P<0.05);治疗组CD63阳性的血小板比例呈逐渐下降趋势,而对照组仅在病后90d才略有下降,治疗组在治疗后90dCD63阳性的血小板比例下降幅度明显大于对照组(P<0.001)。结论:苯妥英钠对血清HDL-c水平有明显的提升作用,对急性脑梗死后血清CD62p及CD63阳性的血小板比例的改变有一定的调节作用。

Objective.To investigate the influence of phenytoin sodium to HDL-c and CD62p/CD63 in patients after recent ischemic stroke. Methods： Sixty-four patients after ischemic stroke were randomly assigned to phenytoin sodium group and control group. Patients in phenytoin sodium group were treatedwith phenytoin sodium 0.2 per day but control group without. At the pretherapy and 30,00days post-treatment the levels of HDL-c ,CD62p, CD63 were studied. ResuRs：In phenytoin sodium group the level of serum HDL-c began stepping up at 30 days post-treatment and it was heightened more obviously at 90days post-treatment（P〈0. 01）. The ratio of platdet with positive CD62p all decreased significantly in the two groups at 30 days post-treatment and it was decreased more dramatically at 90 days post-treatment. The proportion of platelet with positive CD63 in phenytoin sodium group declined gradually after treatment, but in control group it had little decrease at 90 days post-treatment. The proportion of platelet with positive CD63 in phenytoin sodium group droped much more than that in control g（oup at 90 days later. Conclusions.. Phenytoin sodium may height the level of serum HDL-c obviously and it may regulate the change of platelet with positive CD62p/CD63 in patients after recent ischemic stroke.