阿托伐他汀对重型颅脑外伤患者血清炎症介质的影响

Effects of Atorvastatin on Serum Inflammatory Mediators in Patients with Severe Traumatic Brain Injury

目的:观察阿托伐他汀对重型颅脑外伤患者血清炎症介质的影响。方法:116例重型颅脑外伤患者按随机数字表法均分为观察1组(AT1组)、观察2组(AT2组)、观察3组(AT3组)和对照组。所有患者经外科手术或常规保守治疗后,对照组患者给予常规治疗,AT1组、AT2组、AT3组患者在对照组治疗的基础上分别给予阿托伐他汀20、40、80 mg口服,qd。4组患者疗程均为4周。比较4组患者治疗前后超敏C反应蛋白(hs-CRP)、白细胞介素(IL)6、白细胞计数(WBC)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)及格拉斯哥昏迷(GCS)评分的变化;观察4组患者并发症及不良反应发生情况。结果:治疗后4组患者hs-CRP、IL-6、WBC均显著低于同组治疗前,且AT3组<AT2组<AT1组<对照组,4组比较差异有统计学意义(P<0.05);AT1组、AT2组、AT3组患者并发症发生例次均显著低于对照组患者,且AT3组<AT2组<AT1组,4组比较差异有统计学意义(P<0.05);AT1组、AT2组、AT3组患者GCS评分均显著高于对照组患者,且AT3组>AT2组>AT1组,4组比较差异有统计学意义(P<0.05);4组患者ALT、AST及不良反应发生例次比较,差异无统计学意义(P>0.05)。结论:阿托伐他汀用于重型颅脑外伤患者,能减轻炎症反应对脑细胞的损伤,促进脑神经的恢复,改善患者预后。

OBJECTIVE： To observe the effects of atorvastatin on inflammatory mediator in patients with severe traumatic brain injury （STBI）. METHODS： 116 cases of STBI were randomly divided into observation group 1 （AT1 group） and observa-tion group 2 （AT2 group） and observation group 3 （AT3 group）. All patients received surgery or routine expectant treatment; con-trol group was given routine treatment, and AT1 group, AT2 group and AT3 group were additionally given atorvastatin 20, 40 and 80 mg orally, qd, on the basis of control group. Treatment course of 4 groups lasted for 4 weeks. The changes of hs-CRP, IL-6, WBC, ALT, AST and GCS were observed before and after observation. The occurrence of complication and the occurrence of ADR were observed in all patients. RESULTS： After treatment, the levels of hs-CRP, IL-6 and WBC among 4 observation groups were significantly lower than before; the sequence was as follows： AT3 group〈AT2 group〈AT1 group〈control group; there was statistical significance （P〈0.05）. The case number of complication in AT1 group, AT2 group and AT3 group was significantly low-er than in control group; the sequence was as follows： AT3 group〈AT2 group〈ATlgroup; there was statistical significance （P〈 0.05）. GCS of AT1 group, AT2 group and AT3 group were significantly higher than that of control group; the sequence was as fol-lows： AT3 group〉AT2 group〉AT1 group; there was statistical significance （P〈0.05）. There was no statistical significance in ALT and AST and ADR among 4 groups （P〉0.05）. CONCLUSIONS： Atorvastatin can relieve inflammatory reaction-induced brain cell injury and promote the recovery of cerebral nerve and prognosis in patients with STBI.