阿托伐他汀钙片治疗急性缺血性脑卒中的临床疗效观察

Clinical Effect of Atorvastatin Calcium Tablets on Acute Ischemic Stroke

目的观察阿托伐他汀钙片治疗急性缺血性脑卒中的临床疗效。方法选取2013年9月—2015年12月河北省第七人民医院神经内科收治的急性缺血性脑卒中患者82例,采用随机数字表法分为对照组与研究组,每组41例。对照组患者予以常规治疗并口服阿司匹林肠溶片,研究组患者在对照组基础上加用阿托伐他汀钙片治疗;两组患者均连续治疗4周。比较两组患者临床疗效,治疗前后血清炎性因子〔肿瘤坏死因子α(TNF-α)、白介素6(IL-6)、白介素1β(IL-1β)、C反应蛋白(CRP)〕、神经元特异性烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)、S100β蛋白水平及美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数(BI)评分、Fugl-Meyer运动功能评分法(FMA)评分,并观察治疗期间两组患者不良反应发生情况。结果研究组患者临床疗效优于对照组(P<0.05)。治疗前两组患者血清TNF-α、IL-6、IL-1β、CRP水平比较,差异无统计学意义(P>0.05);治疗后研究组患者血清TNF-α、IL-6、IL-1β、CRP水平低于对照组(P<0.05)。治疗前两组患者血清NSE、GFAP、S100β蛋白水平比较,差异无统计学意义(P>0.05);治疗后研究组患者血清NSE、GFAP、S100β蛋白水平低于对照组(P<0.05)。治疗前两组患者NIHSS评分、BI评分、FMA评分比较,差异无统计学意义(P>0.05);治疗后研究组患者NIHSS评分低于对照组,BI评分、FMA评分高于对照组(P<0.05)。治疗期间两组患者均未发生恶心呕吐、肝功能损伤、肌肉疼痛等不良反应。结论阿托伐他汀钙片治疗急性缺血性脑卒中的临床疗效确切,可有效降低患者血清炎性因子水平,改善患者神经功能、生活质量及预后。

Objective To observe the clinical effect of atorvastatin calcium tablets on acute ischemic stroke. Methods From September 2013 to December 2015,a total of 82 patients with acute ischemic stroke were selected in the Department of Neurology,the Seventh Hospital of Hebei Province, and they were divided into control group and study group according to random number table,each of 41 cases. Patients of control group received conventional treatment and oral aspirin enteric- coated tablets,while patients of study group received extra atorvastatin calcium tablets based on that of control group; both groups continuously treated for 4 weeks. Clinical effect,serum levels of inflammatory cytokines（ including TNF-α,IL-6,IL-1β and CRP）,NSE,GFAP and S100β protein,NIHSS score,Barthel index,FMA score before and after treatment,and incidence of adverse reactions duing the treatment were compared between the two groups. Results Clinical effect of study group was statistically significantly better than that of control group（ P 〈 0. 05）. No statistically significant differences of serum level of TNF-α,IL-6,IL-1β or CRP was found between the two groups before treatment（ P 〉 0. 05）; while serum levels of TNF-α,IL-6,IL-1β and CRP of study group were statistically significantly higher than those of control group after treatment（ P 〈 0. 05）.No statistically significant differences of serum level of NSE,GFAP or S100β protein was found between the two groups before treatment（ P 〉 0. 05）,while serum levels of NSE,GFAP and S100β protein of study group were statistically significantly lower than those of control group after treatment（ P 〈 0. 05）. No statistically significant differences of NIHSS score,Barthel index or FMA score was found between the two groups before treatment（ P 〉 0. 05）; after treatment,NIHSS score of study group was statistically significantly lower than that of control group,while Barthel index and FMA score were statistically significantly higher than those of control group（ P 〈 0. 05）. No one of the two groups occurred nausea,vomiting,hepatic injury or muscular pain during the treatment. Conclusion Atorvastatin calcium tablets has certain clinical effect in treating acute ischemic stroke,can effectively reduce the serum inflammatory cytokines levels,improve the neurological function,quality of life and prognosis.