他汀类药物治疗降低缺血性脑卒中患者血清不对称二甲基精氨酸水平

Decrease of serum asymmetric dimethylarginine level in patients with ischemic stroke under statin treatment

目的设计一项前瞻性对照研究,探讨他汀类药物治疗与缺血性脑卒中患者血清不对称二甲基精氨酸(ADMA)之间的关联。方法连续入组门诊非心源性脑卒中患者120例,完成研究117例,其中57例为他汀治疗组(阿托伐他汀20 mg/d),60例为非他汀治疗组。结果治疗前他汀治疗组与非他汀治疗组血清ADMA水平差异无统计学意义(P=0.352);治疗后他汀治疗组较非他汀治疗组血清ADMA水平明显降低(P=0.013)。多元线性回归分析提示,患者年龄(β=0.26,P<0.05)和他汀类药物治疗(β=-0.20,P<0.05)是血清ADMA的独立影响因素,血清胆固醇水平(β=0.00,P=1.00)、低密度脂蛋白胆固醇(LDL-C)水平(β=0.00,P=0.98)不是血清ADMA的独立影响因素。结论他汀类药物治疗与缺血性脑卒中患者血清ADMA降低之间显著相关,可能通过降低血清ADMA水平,预防缺血性脑卒中患者动脉粥样硬化。

Objective To design a prospective and controlled study to explore the relationship between the statin treatment and serum asymmetric dimethylarginine（ADMA） level of patients with ischemic stroke.Methods A total of 120 consecutive outpatients with non-cardiogenic ischemic stroke were selected.Study for117 patients was completed.These patients were divided into the statin treatment group（n=57,treated with atorvastatin of 20 mg/d） and non-statin treatment group（n=60）.Results Before treatment,the difference of serum ADM A level of two groups was not statistically significant（P=0.352）.After treatment,the serum ADM A level of the statin treatment group was significantly lower than that of the non-statin treatment group（P=0.013）.Multiple linear regression analysis showed that the age（β=0.26,P〈0.05） and statin treatment（β=-0.20,P〈0.05） were independent influencing factors of serum ADMA level,but serum cholesterol level（β=0.00,P =1.00） and low density lipoprotein level（β=0.00,P=0.98） were not independent influencing factors of serum ADMA level.Conclusion The statin treatment is significantly correlated with the decrease of serum ADMA level of patients with ischemic stroke and may prevent atherosclerotic diseases for patients with ischemic stroke by decreasing the serum ADMA level.