不同剂量阿托伐他汀对急性脑梗死患者超敏C反应蛋白S100B蛋白水平及神经功能缺损的影响

Effects of atorvastatin in different dose on serum levels of hs-CRP S100B protein and neurological impairment in patients with acute cerebral infarction

目的观察不同剂量阿托伐他汀对急性脑梗死患者超敏C反应蛋白(hs-CRP)、S100B水平及神经功能的影响,探索大剂量阿托伐他汀对脑梗死急性期治疗的益处。方法选择急性脑梗死患者96例,随机分为治疗组与对照Ⅰ组、对照Ⅱ组。治疗组服用阿托伐他汀40 mg/d,对照Ⅰ组服用阿托伐他汀20 mg/d,对照Ⅱ组服用阿托伐他汀10 mg/d,其余治疗均相同。分别于治疗前及治疗7、14 d后检测患者血清hs-CRP和S100B水平,评价神经功能缺损程度。结果治疗7 d后,治疗组hs-CRP水平明显下降(P<0.05),对照Ⅰ、Ⅱ组hs-CRP水平下降均不明显(P>0.05)。治疗组S100B水平较治疗前显著下降(P<0.05),对照Ⅰ、Ⅱ组S100B水平变化不明显(P>0.05)。治疗14 d后,治疗组hs-CRP水平进一步下降(P<0.05),对照Ⅰ、Ⅱ组血清hs-CRP水平有明显下降(P<0.05)。治疗组S100B水平进一步下降(P<0.05),对照Ⅰ组S100B水平较治疗前明显下降(P<0.05),对照Ⅱ组S100B水平变化不明显(P>0.05)。治疗后,3组神经功能缺损情况均较治疗前有不同程度改善(P<0.05),与对照组相比治疗组改善更明显。结论相对20 mg/d、10 mg/d的阿托伐他汀治疗急性脑梗死,40 mg/d的剂量可更明显降低hs-CRP、S100B蛋白水平,改善患者的神经功能缺损,有益于改善患者预后。

Objective To investigate the effects of atorvastatin in different dose on serum levels of hs-CRP,S100 B protein and the neurological impairment in patients with acute cerebral infarction,so as to explore the benefits of large doses of atorvastatin on acute cerebral infarction. Methods Ninety-six patients with acute cerebral infarction were enrolled and randomized into treatment group,controlⅠgroup and control Ⅱ group. Treatment group received atorvastatin 40 mg / d,control Ⅰgroup 20 mg / d,and control Ⅱ group 10 mg / d. The remaining treatment of the three groups was the same. The serum levels of hs-CRP,S100 B protein and the neurological impairment were evaluated before treatment and 7,14 days after treatment respectively. The measured results were statistically analyzed. Results 7 days after treatment,the serum levels of hs-CRP decreased significantly in treatment group( P < 0. 05),and hs-CRP levels in controlⅠgroup and controlⅡgroup did not change obviously( P > 0. 05). The levels of S100 B in treatment group dropped more sharply than that before treatment( P <0. 05),S100 B protein levels had no obvious change in controlⅠgroup and controlⅡ group( P > 0. 05). 14 days after further treatment,hsCRP levels decreased further in treatment group( P < 0. 05),and the levels of hs-CRP in controlⅠ group and control Ⅱ group also had obvious decline( P < 0. 05). S100 B protein levels declined further in treatment group( P < 0. 05). The levels of S100 B in control Ⅰ group decreased more significantly than that before treatment( P < 0. 05),and it did not change obviously in control Ⅱ group( P > 0. 05). The neurological impairment was progressively improved in all groups( P < 0. 05),but the improvement was more marked in the treatment group.Conclusion Treatment with 40 mg / d atorvastatin can reduce the levels of hs-CRP and S100 B protein more obviously than treated with 20 mg / d and 10 mg / d atorvastatin,and the effect on acute cerebral infarction is better.