阿托伐他汀钙对脑梗死的治疗作用及对Hs-CRP、IL-6、TNF-α炎症因子的影响

Clinical effects of Atorvastatin treatment on cerebral infarction and its impact on Hs-CRP, IL-6, and TNF-α

目的观察阿托伐他汀钙对脑梗死的治疗作用,探讨其可能的作用机制。方法收集该院2012年1月-2012年8月收治的脑梗死患者96例,随机分为两组：常规治疗对照组和阿托伐他汀钙治疗组,每组48例。对照两组血脂的变化、临床疗效、药物不良反应和随访复发率。Hs-CRP采用免疫比浊法测定,IL-6和TNF-α表达水平的检测使用ELISA法。结果治疗前对照组和阿托伐他汀钙治疗组TC、LDL-C和HDL-C的表达水平差异无统计学意义（P〉0.05）。治疗后各组TC、LDL-C的表达水平均较治疗前显著减低（P〈0.05）,HDL-C的表达水平则较治疗前显著升高（P〈0.05）,然而TC、LDL-C和HDL-C表达水平治疗前后的变化在阿托伐他汀钙治疗组显著高于对照组（P〈0.05）。对照组和阿托伐他汀钙治疗组的临床疗效有效率分别为64.6%和83.3%,阿托伐他汀钙治疗组的临床疗效显著优于对照组（P〈0.05）。治疗前对照组和阿托伐他汀钙治疗组Hs-CRP、IL-6和TNF-α的表达水平差异无统计学意义（P〉0.05）。治疗后各组Hs-CRP、IL-6和TNF-α的表达水平均较治疗前显著减低（P〈0.05）,阿托伐他汀钙治疗组Hs-CRP、IL-6和TNF-α水平的减低显著优于对照组（P〈0.05）。对照组和阿托伐他汀钙治疗组的药物不良反应率分别为6.3%和8.3%,两组之间差异无统计学意义（P〉0.05）。阿托伐他汀钙治疗组的复发率为4.2%,显著低于对照组的14.6%。结论该研究显示阿托伐他汀钙治疗脑梗死临床疗效显著,无显著药物不良反应,值得临床推广应用,调节血脂及减弱Hs-CRP、IL-6和TNF-α的抗炎作用可能是其作用的主要机制。

[ Objective ] To investigate the clinical effects of Atorvastatin treatment on cerebral infarction and its impact of Hs-CRP, IL-6, and TNF-α. [Methods] A total of 96 patients with cerebral infarction were enrolled in this study. All cases were divided into two groups： control group （n =48） and Atorvastatin treat- ment group （n =48）. The change of blood-fat, clinic effects, adverse reactions, and recurrence was compared between the two groups. The levels of serum hs-CRP was measured with Latex enhanced immunoturbidimetric assay. The expression of IL-6 and TNF-α was measured by fluorescence immunoassay. [ Results] The expres- sion of TC, LDL-C and HDL-C was no significant difference between the two groups at pretreatment （P〉 0.05）. Compared with pretreatment, the expression of TC and LDL-C was significantly decreased at post-treatment in the two groups （P〈0.05）. However, the expression of HDL-C was significantly increased at post-treat-ment in the two groups （P 〈0.05）. The changes of TC, LDL-C and HDL-C were significantly better in treat- ment group than that in control group （P〈0.05）. The clinic effective rate in control and treatment group was 64.6% and 83.3%. The clinic effective rate in treatment group was higher than that in control group （P 〈 0.05）. The expression of Hs-CRP, IL-6, and TNF-α was no significant difference between the two groups at pretreatment （P〉0.05）. Compared with pretreatment, the expression of Hs-CRP, IL-6, and TNF-α was signifi- cantly decreased at post-treatment in the two groups （P〈0.05）. The changes of Hs-CRP, IL-6, and TNF-α were significantly better in treatment group than that in control group （P〈0.05）. The clinic adverse reactions in control and treatment group was 6.3% and 8.3%. There was no significant difference between the two groups （P〉0.05）. The recurrence rate in treatment group was 4.2%, which was lower than that of 14.6% in control group （P〈0.05）. [Conclusion] Atorvastatin treatment showed more effectively on patients with ischemic stroke with less clinical adverse reactions, and which was worthy to promote the clinical application. Regula- tion of fat and down-regulation of Hs-CRP, IL-6, and TNF-α maybe the mechanism of its clinic efficacy.