强化降脂治疗对急性脑梗死患者血清炎症因子hs-CRP、IL-8、IL-6及MMP-9水平的影响

Effect of high-dose atorvastatin on the inflammatory factors such as hs-CRP,IL-8,IL-6 and MMP-9 in acute stage of cerebral infarction

目的探讨短期内使用阿托伐他汀强化降脂对急性脑梗死患者血清高敏C反应蛋白(hs-CRP)、白细胞介素-8(IL-8)、白细胞介素-6(IL-6)及基质金属蛋白酶-9(MMP-9)的影响,以了解其对脑梗死炎症抑制和颈动脉斑块稳定作用。方法 120例急性脑梗死患者患者根据颈动脉超声检查结果分为颈动脉稳定斑块组(n=60)和颈动脉易损斑块组(n=60)。抽血检查后随机分为常规治疗组60例(阿托伐他汀10mg/d,口服)和强化治疗组60例(阿托伐他汀40mg/d,口服)。所有患者药物治疗前和治疗后2w检测血脂及血清hs-CRP、IL-8、IL-6和MMP-9水平。结果治疗前常规治疗组和强化治疗组中血脂及血清hs-CRP、IL-8、IL-6和MMP-9水平差异无显著性(均P>0.05)。治疗后2w,强化治疗组中LDL-C、血清hs-CRP水平明显低于常规治疗组,差异具有著性(P<0.01),强化治疗组中两亚组(尤其是易损斑块组)血清IL-8、IL-6和MMP-9水平明显低于常规治疗组,差异具有显著性(P<0.01)。结论阿托伐他汀强化降脂能迅速降低脑梗死患者的血清炎症因子水平,具有抑制炎症和稳定斑块的作用。

Objective To observe the effect of short-term high-dose atorvastatin on the inflammatory factors such as high sensitivity C-reactive protein（hs-CRP）,interleukin-8（IL-8）,interleukin-6（IL-6）and marix metalloproteinases-9（MMP-9）in patients with acute stroke,and to demonstrate whether or not atorvastatin could aggressively inhibit inflammation and stabilize the atherosclerosis plaque.Methods One hundred and twenty acute cerebral infarction patients from the Department of Neurology of the Fifth Hospital of Wuhan City were divided into carotid vulnerable plaque group and carotid stable plaque group according to the results of carotid B-mode ultrasonography.There were 60 patients in each group.They were randomly divided into conventional therapy group（n=60）and High-dose atorvastatin group（n=60）.Patients in the conventional therapy group received low-dose（10mg/d）atorvastatin,whereas patients in High-dose atorvastatin group received atorvastatin 40mg/d.Blood lipoprotein,hs-CRP,IL-8,IL-6 and MMP-9 were measured in all patients before treatment and two-weeks after therapy.Results Before treatment,there were no significant differences in blood lipoprotein,Hs-CRP,IL-8,IL-6 and MMP-9 between the conventional group and High-dose atorvastatin group（P0.05）.There was an obvious decreases in the level of LDL-C and hs-CRP in patients treated with High-dose atorvastatin for 2 weeks（P0.01）.There was an obvious decreases in the level of IL-8,IL-6 and MMP-9 in patients who had carotid vulnerable plaques and treated with High-dose atorvastatin for 2 weeks（P0.01）.Conclusion High-dose atorvastatin could rapidly reduce serum inflammatory factors in patients with acute stroke,and might inhibit inflammation and stabilize atherosclerosis plaque.