强化降脂治疗急性脑梗死108例临床观察

Clinical Observation on Trealment of 108 Cases of Acute Cerebral Infraetion of Intensive Liqid Lowering

目的观察不同剂量阿托伐他汀对急性脑梗死(ACI)患者的血脂、血清炎性因子[超敏C-反应蛋白(hsCRP)、基质金属蛋白酶-9(MMP-9)和肿瘤坏死因子-α(TNF-α)]的影响。方法我院急性脑梗死患者随机分为阿托伐他汀常规治疗组、阿托伐他汀强化降脂组和对照组各36例,阿托伐他汀常规组治疗组予以脑梗死基础治疗+阿托伐他汀10mg,每晚1次;阿托伐他汀强化降脂组予以脑梗死基础治疗+阿托伐他汀40mg,每晚1次;对照组予以脑梗死基础治疗+安慰剂10mg,每晚1次。治疗前后检测患者的血脂、CRP、MMP-9、TNF-α。结果强化降脂组及常规组中血清血脂及CRP、TNF-α、MMP-9水平均明显低于对照组,而且强化降脂组中血清血脂及CRP、TNF-α、MMP-9水平均低于常规组,三组差异均有统计学意义(P<0.01)。结论他汀强化降脂治疗能显著降低ACI患者的血清炎性因子,具有更强的抗炎作用,可提高易损斑块的稳定性。

Objective To observe size different doses simvastatin acute cerebral infarction patients of the blood, serum inflammatory factor （allergic C-c-reactive protein （CRP）, Matrix metalloproteinase-9（MMP-9） and hs-tumor necrosis factor alpha （ TNF alpha） ） influence. Methods Acute cerebral infarction our patients were randomly divided into Simvastatinsimvastatin rou-tine therapy group, Simvastatinsimvastatin intensive lipid-lowering group and control group every 36 cases, Simvastatinsimvastatin conventional group to cerebral infarction treatment group based therapy ＋ Simvastatinsimvastatin, 10mg qn;：Simvastatin simvasta-tin intensive lipid-lowering group based therapy to cerebral infarction ＋ Simvastatinsimvastatin, 40mg qn;group based therapy to cerebral infarction 10mg qn, placebo, ＋ test before and after the treatment of patients with lipid levels, CRP, MMP-9, TNF al-pha. Results Intensive lipid-lowering groups and regular groups in serum lipid and CRP, MMP-9, TNF alpha levels were signifi-cantly lower than those in control group, and intensive lipid-lowering serum lipid group and CRP, MMP-9, TNF alpha levels were lower than that of the conventional group, three groups was statistically significant difference（P〈 0. 01）. Conclusion Statin in-tensive lipid-lowering therapy Could significantly reduce inflammatory cytokines in serum of patients with ACI,have a stronger an-ti-inflammatory effect, improve the stability of the vulnerable plaque Acute cerebral infarction more intensive lipid-lowering therapy can reduce serum lipid and CRP, TNF alpha level, to recover from illness.