瑞舒伐他汀对脑血管狭窄支架置入前后炎性因子的影响

Effect of rosuvastatin on inflammatory fator before and after stent implantation in patients with cerebral vascular stenosis

目的观察瑞舒伐他汀对无脂代谢紊乱的脑血管狭窄患者支架置入前后超敏C反应蛋白(hs-CRP)及肿瘤坏死因子-α(TNF-α)的影响,探讨瑞舒伐他汀预防脑血管狭窄支架术后再狭窄的可能性。方法将90例成功置入支架的无脂代谢紊乱的脑血管狭窄患者随机分为阿托伐他汀钙20 mg组(A组30例)、瑞舒伐他汀10 mg组(B组30例)、瑞舒伐他汀20 mg组(C组30例),于支架置入前、术后24 h及术后3个月分别抽取外周血进行血脂、hs-CRP及TNF-α测定并进行比较。结果术后3个月3组血脂水平均较前降低,尤以LDL-C下降明显,C组较A组、B组下降明显;C组术后3个月HDL-C较前升高。24 h 3组hs-CRP及TNF-α均较术前升高,但3组间比较均无显著性差异;术后3个月3组hs-CRP及TNF-α均较术前及术后24 h下降,C组下降幅度明显高于A组和B组。结论支架置入术后hs-CRP及TNF-α浓度升高,大剂量瑞舒伐他汀可使无脂代谢紊乱的脑血管狭窄支架置入术后患者的炎性因子水平明显降低,对脑血管狭窄支架术后再狭窄有一定的预防作用。

Objective It is to observe the effect of rosuvastatin on the high sensitive C -reactive Protein（ hs -CRP）and tumor necrosis factor- ot（TNF- or） before and after stent implantation in patients with cerebral vascular stenosis and without fat metabolic disorder, and to explore the possibility of this drug for preventing restenosis after stent implantation. Methods 90 patients with cerebral vascular stenosis after successful stent implantation were divided randomly into three groups： group A（ n = 20） were given atorvastatin 20 rag, group B （n = 30） were given rosuvastatin 10 rag, group C （n = 30） were given rosuvastatin 20mg. Peripheral blood samples were gotten to detect and compare the levels of blood lipids, hs - CRP and TNF - c~ before and after 24 hours＇stent implantation and after 3 months＇stent implantation. Results The levels of blood lipids in 3 months after surgery were lower than that before surgery, especially LDL - C decreased significantly, and the decrease degrees in group C were more obviously than that in group A and group B. HDL - C in 3 months after surgery in group C was increased,. The levels of hs - CRP and TNF - ct in 24 hours after surgery were higher than that before surgery in all groups, but there was no significant difference among the three groups. The levels of hs - CRP and TNF - ct in 3 months after surgery were lower than before surgery and in 24 hours after surgery, and the decrease degree of group C was more than that in group A and group B. Conclusion The levels of hs - CRP and TNF - ct after stent implantation increase, high-dose of atorvastatin can decrease the levels of inflammatory factors after stent implantation in patients with cerebral vascular stenosis, so it can reduce possibility of restenosis after stent implantation on cerebral vascular stenosis .