吲哚美辛对脑梗死急性期炎症反应的影响

Effect indomethacin on acute inflammatory response in patients with acute cerebral infarction

目的研究吲哚美辛对急性脑梗死(ACI)患者血清C反应蛋白(CRP)及可溶性细胞间粘附分子-1(sICAM-1)水平的影响,探讨吲哚美辛对脑梗死急性期炎症反应的影响。方法将60例ACI患者随机分为吲哚美辛治疗组和常规治疗组,并选取正常体检者30人组成对照组。在治疗前及治疗第7天、第14天检测血清CRP和sICAM-1含量,并进行神经功能缺损程度评分(NIHSS)评定。结果两组治疗前血清sICAM-1、CRP含量较对照组显著升高(P<0.01),治疗后较治疗前显著下降(P<0.01),且吲哚美辛治疗组较常规治疗组下降显著(P<0.05);两组治疗14d时NIHSS较治疗前显著下降(均P<0.01),且吲哚美辛治疗组较常规治疗组下降明显(P<0.05);吲哚美辛治疗组未出现明显副反应,耐受性良好。结论吲哚美辛能明显降低ACI患者血清CRP及sICAM-1水平;有助于ACI患者的神经功能恢复并且安全性较好。

Objective To study the effect of indomethacin on the level of serum C-reactive protein and soluble intercellular adhesion molecule-1（Siam-1） and inflammatory response in patients with acute cerebral infarction（ACI）.Methods 60 patients with ACI were randomly divided into the indomethacin therapy group and the conventional therapy group.Thirty healthy people were selected simultaneously as controls.On 7d and 14d before and after treatment,serum CPR,Siam-1 levels and the scores of neurological deficit（NDS） were evaluated.Results Before treatment,serum sICAM-1 and CRP levels of treatment groups was significantly higher than the control group（P 〈0.01）,while after treatment,decreased（P〈0.01）.Indomethacin treatment group compared with conventional treatment group,serum sICAM-1 and CRP levels decreased significantly（P〈0.05）.In two groups,NIHSS of 14d was significantly decreased than before treatment（P〈0.01）,and compared with conventional treatment group,that of indomethacin treatment group decreased significantly（P〈0.05）.Indomethacin treatment group showed no significant side effects and good tolerability.Conclusion Indomethacin significantly decreased the serum CRP in patients with ACI and sICAM-1 level,and may help to restore neurological function in patients with ACI and shows good safety.