瑞舒伐他汀钙对急性脑梗死患者血清VCAM-1ICAM-1和PAI-1的影响

Clinical studies of the effect of rosuvastatin on serum concentrations of VCAM-1, ICAM-1 and PAI-1 in the patients with acute cerebral infarctionClinical studies of the effect of rosuvastatin on serum concentrations of VCAM-1, ICAM-1 and PAI-1 in the patients with acute cerebral infarction

目的 探讨瑞舒伐他汀钙对急性脑梗死（ACI）患者血清中血管细胞间黏附分子-1 （VCAM-1）、细胞间黏附分子-1（ICAM-1）和纤溶酶原激活物抑制剂-1（PAI-1）的影响.方法 发生ACI 24 h以内入院的患者共有133例,随机分为68例瑞舒伐他汀钙治疗组和65例常规治疗组,同时以45例健康体检人员作为对照组.急性脑梗死患者分别于发病确诊后第1、3天和第1、2、3周抽取血液,采用酶联免疫吸附剂法（ELISA）测定VCAM-1、ICAM-1和PAI-1浓度.结果 ACI患者血清VCAM-1、ICAM-1 和PAI-1浓度在第1天即升至最高值.ACI患者第3天至第2周血清VCAM-1和ICAM-1浓度仍显著高于对照组（P＜0.05）.与常规治疗组相比,瑞舒伐他汀钙组患者在第3天、第1周和第2周血清VCAM-1、ICAM-1浓度显著降低（P＜0.05）.与常规治疗组相比,瑞舒伐他汀钙组患者在第3天血清PAI-1浓度即显著降低（P＜0.05）.治疗1周后,常规治疗组患者血清PAI-1浓度仍显著高于对照组（P＜0.05）.结论 瑞舒伐他汀钙可降低ACI患者血清VCAM-1、ICAM-1和PAI-1浓度,具有抗黏附、促纤溶作用,这可能是瑞舒伐他汀钙抗炎症反应的机制之一.

Objective To investigate the effects of rosuvastatin on serum concentrations of vascular cell adhesion molecule - 1 （VCAM - 1 ） , intercellular adhesion molecule - 1 （ ICAM - 1 ） and plasminogen activator inhibitor - 1 （PAI - 1 ） in patients with acute cerebral infarction （ACI）. Methods Hospitalized 133 patients with ACI were randomly divided into two groups： sixty -eight patients were treated with rosuvastatin and the conventional treatment methods, and sixty -five patients with only conventional treatment. The serum concentrations of VCAM - l, ICAM - 1 and PAl - 1 were detected on the 1st, 3rd day after the onset of ACI and 1st, 2nd and 3rd week following the treatment. At the same time, these indexes were detected in the control group （45 healthy volunteers）. Results The serum concentrations of VCAM - 1 and ICAM - 1, PAl - 1 rose to peak point in patients with ACI on the 1 st day. After three - day and two - week treatment, the serum concentrations of VCAM - I and ICAM - I in patients with ACI remained significantly higher level than those in control group （P 〈 0.05 ）. The serum concentrations of VCAM - 1, ICAM - 1 were significantly lower in rosuvastatin treatment group than in the conventional treatment group 3rd day, 1st and 2nd week after treatment （P 〈 0.05）. Compared to conventional treatment group, serum levels of PAl - 1 in rosuvastatin treatment group were significantly lower after 3 - day treatment （ P 〈 0.05 ）. One week after treatment, the serum levels of PAI- 1 in the conventional treatment group were still significantly higher than those in control group （P 〈 0.05）. Conclusion Rosuvastatin may be beneficial to lowering serum concentration of VCAM -1, ICAM - 1 and PAI - 1, counteracting adhesion and Promoting fibrinolytie, restraining the inflammation and improving microcirculation. This may be the anti - inflammatory mechanisms of rosuvastatin.