辛伐他汀对急性脑卒中患者血清脂联素和不对称性二甲基精氨酸水平的影响

The effect of simvastatin on the level of serum adiponectin and asymmetric dimethylarginine in patients with acute stroke

目的探讨辛伐他汀对急性脑卒中患者血清脂联素和不对称性二甲基精氨酸（ADMA）水平的影响。方法选择急性脑卒中患者90例，按随机数字表法分为常规治疗组和干预治疗组，每组45例。计算两组患者脑梗死体积和临床神经功能缺损程度评分。酶联免疫吸附试验法检测两组治疗前后血清脂联素和ADMA水平。比较两组治疗前后脂联素和ADMA水平的变化，并分析其与脑梗死体积和临床神经功能缺损程度评分的相关性。结果治疗前两组患者脂联素和ADMA水平比较差异无统计学意义（P〉0．05）；治疗后两组患者脂联素水平明显升高，ADMA水平明显下降，与治疗前比较差异有统计学意义（｜P〈0．05）。但是干预治疗组治疗后脂联素水平明显高于同期常规治疗组，ADMA水平明显低于同期常规治疗组，差异有统计学意义[（5．92±0．15）mg／L比（4．51±0．13）mg／L，（0．96±0．13）±mol／L比（1．08±0．15）μmol／L]（P〈0．05）。等级相关分析结果显示患者治疗前脂联素水平与脑梗死体积和临床神经功能缺损程度评分均呈负相关，相关系数分别为-0．75和-0．59，P值均〈0．05。患者治疗前ADMA水平与脑梗死体积和临床神经功能缺损程度评分均呈正相关，相关系数分别为0．68和0．71，P值均〈0．05。结论辛伐他汀能有效地升高急性脑卒中患者脂联素水平和降低ADMA水平，改善患者预后。

Objective To explore the effect of simvastatin on the level of serum adiponectin and asymmetric dimethylarginine （ADMA） in patients with acute stroke. Methods Ninety patients with acute stroke were selected and divided by random digits table method into common treatment group and intervention treatment group with 45 cases each. The volume of cerebral infarction and the evaluation score of clinical neurological impairment degree were calculated. The levels of serum adiponectin and ADMA before and after treatment were detected by enzyme-linked immunosorbent assay. The changes of serum adiponeetin and ADMA before and after treatment in two groups were compared and their correlations with the volume of cerebral infarction and the evaluation score of clinical neurological impairment degree were analyzed. Results The level of serum adiponeetin and ADMA in two groups before treatment had no statistical differences （P 〉 0.05）. The levels of serum adiponeetin in two groups after treatment increased and ADMA decreased significantly, which had significant differences compared with those before treatment （P 〈 0.05 ）. The level of serum adiponectin in intervention treatment group was significantly higher than that in common treatment group and ADMA was obviously lower than that in common treatment group after treatment [ （5.92± 0.15） mg/L vs. （ 4.51 ± 0.13 ） mg/L, （ 0.96 ± 0.13 ）μmol/L vs. （ 1.08 ± 0.15 ）μ mol/L ] （P 〈 0.05 ）. Rank correlation analysis showed that the level of serum adiponectin before treatment was negatively correlated with the volume of cerebral infarction and the evaluation score of clinical neurological impairment degree （r = -0.75 ,-0.59, P 〈 0.05 ）. The level of ADMA before treatment was positively correlated with the volume of cerebral infarction and the evaluation score of clinical neurological impairment degree （r = 0.68,0.71 ,P 〈 0.05）. Conclusion Simvastatin can increase the level of serum adiponeetin and decrease the level of ADMA eitieiently in patients with acute stroke, and improve the prognosis of the patients.