辛伐他汀对脑梗死患者急性期炎症因子的影响及安全性评价

Evaluation of influence of simvastatin on inflammatory factor and safety on ischemic stroke of acute stage

目的:探讨辛伐他汀对神经和血管保护作用的药理机制,并对辛伐他汀的安全性进行评价。方法:对98例脑梗死患者随机分为3组:A组37例(基础用药+辛伐他汀20mg.d-1);B组28例(基础用药+辛伐他汀40mg.d-1);对照组33例(基础用药)。分别在入院第2、15天做相关检查。结果:(1)炎症因子:C-反应蛋白在A组及B组用药15d后明显下降,与对照组比较差异有显著性(P<0.05);α-酸性糖蛋白及触珠蛋白在B组明显下降,与对照组比较差异有显著性(P<0.05)。(2)活化血小板在B组用药15d后较用药前上升幅度明显减小,与A组及对照组比较差异有显著性(P<0.05)。(3)胆固醇在A组及B组用药15d后均明显下降,与对照组比较差异有显著性(P<0.05),A、B两组间比较无统计学意义。(4)B组用药15d后外周血血小板计数明显下降,与对照组和A组比较差异有显著性(P<0.05)。(5)A、B组用药15d后谷丙转氨酶和谷草转氨酶明显上升,与对照组比较差异有显著性(P<0.05)。结论:(1)脑梗死急性期应用辛伐他汀,可出现炎症因子和外周血血小板计数降低以及活化血小板升高幅度减小等非调脂作用。B组作用强于A组,呈现一定的量效关系。(2)脑梗死患者急性期应用辛伐他汀后出现胆固醇降低,上述两种作用在A组与B组比较未见明显差异。(3)服用辛伐他汀可出现可逆性肝功能损害,肝功能损害可能与患者的个体差异有关。

OBJECTIVE To explore the Pharmacological mechanism of simvastatin on the protection of nerves and blood vessel factors,and evaluae the safety of simvastatin on ischemic stroke of acute stage. METHODS 98 patients were divided into three groups randomly： group A 37 cases （elementary medication ＋ Simvastatin 20 mg·d^-1）,group B 28 cases （elementary medication ＋ Simvastatin 40 mg·d^-1）,and control group 33 cases（elementary medication）. Necessary examination were carried out at the second day and the 15^th day. RESULTS 1. Inflammatory factor： Compared with control group,CRP was lowered significantly （P〈0. 05） in group A and group B,AAG and HPT was lowered significantly （P〈0. 05）in group B at the 15^Th day. 2. Compared with other two groups, the rising scope of CD62p in group 13 were lowered significantly at the 15^th day （P〈0. 05）. 3. Compared with control group, CHOL was lowered in A and 13 6 groups（Both P〈0. 05）, but there was no difference of CHOL among group A and group 13. 4. The number of platelet in group 13 were lowered significantly at the 15^th day （P〈0. 05） compared with the other two groups. 5. Compared with control group, the GPT and the GOT were heighten significantly （P〈0. 05） in group A and group 13 at the 15^th day. CONCLUSION 1. On ischemic stroke of acute stage, simvastatin could decrease the factors of inflammation,the number of platelet, rising scope of CD62p and CHOL in acute cerebral infarction,the effect in group 13 was greater than that in group A, there was a relation between dosage and curative effect.. 2. On ischemic stroke of acute stage, simvastatin could decrease CHOL, but there was no difference among group A and group B. 3. Simvastatin could cause hepatic function reversible lesion, the functional lesion may be related to individual variation.