阿托伐他汀预先干预对急性脑梗死患者的神经保护作用

Neuroprotective effect of atorvastatin calcium pre-intervention in patients with acute cerebral infarction

目的探讨阿托伐他汀预先干预对急性脑梗死的神经保护作用。方法 80例急性脑梗死患者按照就诊前3个月是否服用阿托伐他汀钙为他汀组40例和对照组40例,入院后对照组给予常规治疗,而不用他汀类药物,他汀组在对照组治疗的基础上继续口服阿托伐他汀。均在发病72h时比较2组患者:(1)生化检测指标:血浆超敏C反应蛋白(hs-CRP)、血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及内皮素-1(ET-1)水平。(2)脑梗死灶体积。(3)神经功能缺损评分。(4)日常生活能力评分。结果发病72h时,他汀组患者的hs-CRP、IL-6、TNF-α、ET-1、梗死灶体积及神经功能缺损程度评分均显著低于对照组(t=3.7975,3.0319,3.2543,2.1146,2.0766,2.1636,P<0.01或P<0.05),他汀组患者的Barthel指数显著高于对照组(t=2.2593,P<0.05)。结论阿托伐他汀预先干预对急性脑梗死具有神经保护作用,可降低炎性因子超敏C反应蛋白、白细胞介素-6、TNF-α及内皮素-1水平,缩小脑梗死灶体积,减轻神经功能缺损,提高日常生活能力。

Objective To investigate the neuroprotective effect of atorvastatin calcium pre-intervention in patients with acute cerebral infarction.Methods Total 80 patients with acute cerebral infarction were divided into statin group（40 cases） and control group（40 cases） according to whether they took atorvastatin calcium（20 mg,qd） treatment before 3 months,the control group received conventional treatment after admission,and did not use statins;the statin group received atorvastatin treatment on the basis of the control group after admission.In the two groups,plasma high-sensitivity C-reactive protein（hs-CRP）,serum interleukin-6（IL-6）,tumor necrosis factor-α（TNF-α） and endothelin-1（ET-1） levels,infarct volume,neurological deficit score,daily living score were compared at the 72-hour onset.Results The levels of hs-CRP,IL-6,TNF-α,ET-1,and infarct volume and neurological deficit scores in the statin group were significantly lower than those of control group at incidence of 72 hours（t=3.7975,3.0319,3.2543,2.1146,2.0766,2.1636,P0.01 or P0.05）,Barthel index in the statin group was significantly higher than that of the control group（t=2.2593,P0.05）.Conclusion Atorvastatin has a neuroprotective effect on acute cerebral infarction,and can reduce the inflammatory factor C-reactive protein,interleukin-6,TNF-α and endothelin-1 levels,reduce infarct size,reduce neurological deficit,and improve daily living.