辛伐他汀拮抗高同型半胱氨酸对脑血管病的致病作用

Antagonization of Simvastatin aganinst Effects of Homocysteic Acid on Cerebrovascular Diseases

目的观察辛伐他汀拮抗高同型半胱氨酸对脑血管病的致病作用。方法将212例高同型半胱氨酸血症所导致的脑血管病患者随机分成对照组和治疗组各106例。对照组给予维生素B12、维生素B6、叶酸治疗,治疗组加用辛伐他汀20 mg.d-1口服直至出院后2 a,比较两组患者高同型半胱氨酸浓度、治愈率、病死率、2 a内的复发率之间的差异。结果辛伐他汀降低高同型半胱氨酸血症远期效果好于维生素B12、维生素B6和叶酸治疗,治疗组患者治愈率明显高于对照组(P<0.01),病死率明显低于对照组(P<0.01),2 a复诊期间治疗组患者死于脑血管意外的病死率低于对照组(P<0.05),复发率低于对照组(P<0.05),复诊时有伴随症状人次率低于对照组(P<0.05)。结论辛伐他汀对高同型半胱氨酸所致脑血管病具有明显的拮抗作用,对治疗高同型半胱氨酸血症所致的脑血管病具有潜在的临床应用价值,从而更好地预防和治疗脑血管疾病。

Objective To investigate the antagonization of simvastatin against effects of hyperhomocysteinemia inducing cerebrovascular diseases. Methods 212 patients with cerebrovascular diseases by hyperhomocysteinemia were randomly divided into the treatment group （n = 106）and the control group（n = 106）. The control group was given VitB6 ,VitB12 and folic acid, while the treatment group was given simvastatin （20 mg · d^-1 ） till discharge. The healing rate, death rate and relapse rate were compared between two groups. Results The cure rate in the simvastatin group was obviously higher than that in the control group（P 〈 0.01 ）, the death rate and the relapse rate in the simvastatin group was lower than that in the control group （ P 〈 0.01 and P 〈 0.05 ）, and the patients rediagnosed with accompanying symptoms in the former were fewer （ P 〈 0.05 ）. Conclusion Simvastatin significantly antagonized to the effects of hyperhomocysteinemia on cerebral diseases, which has the potential clinical application value for preventiing and curing cerebral diseases.