瑞舒伐他汀强化降脂对缺血性脑卒中患者血管内皮功能的影响及疗效观察

Influence and curative effect observation of rosuvastatin intensive lipid-lowering on vascular endothelial function of patients with ischemic stroke

目的探讨瑞舒伐他汀强化降脂对缺血性脑卒中患者血管内皮功能的影响及疗效。方法将90例急性脑梗死患者随机分为强化组(n=45)和普通组(n=45)。两组均予以控制颅内压、血压和血糖、抑制血小板聚集、神经保护等基础治疗。普通组在此基础上口服瑞舒伐他汀片10 mg,1次/d;强化组在此基础上口服瑞舒伐他汀片20 mg,1次/d,两组均连用8周。检测并比较两组治疗前后血清血管性假血友病因子(v WF)、血栓调节蛋白(TM)和血管内皮细胞钙黏蛋白(VE-cadherin)水平的变化,并比较其临床效果及不良反应。结果治疗8周后,两组血清v WF、TM和VE-cadherin水平较前均不同程度下降,且强化组下降幅度比普通组更显著(P<0.05);同时在临床总有效率上强化组(95.56%)明显优于普通组(82.22%)(χ~2=4.05,P<0.05)。普通组和强化组治疗中分别出现不良反应3例(6.67%)和6例(13.33%),症状较轻,两组比较差异不明显(χ~2=0.49,P>0.05)。结论瑞舒伐他汀强化降脂治疗缺血性脑卒中的疗效显著,能明显改善其神经功能缺损程度,安全性较好,其作用机制与其能降低血清v WF、TM和VE-cadherin水平,修复受损的血管内皮,减少动脉易损斑块破裂,提高其稳定性密切相关。

Objective To discuss the influence and curative effect observation of rosuvastatin intensive lipid-lowering on vascular endothelial function of patients with ischemic stroke. Methods 90 cases of patients with ischemic stroke were divided into strengthened group （n=45） and ordinary group （n=45）. The patients in two groups were given basic medical treatment, such as reducing intracranial pressure and dehydration, control of blood pressure and blood sugar, antiplatelet aggregation, neural protection and etc. The patients in ordinary group were given oral 10mg rosuvastatin Calcium Tablets, once a day, while the patients in strengthened group were additionally given 20 mg rosuvastatin Calcium Tablets, once a day for 8 weeks. The changes of serum Von willebrand factor （vWF）, Thrombomodulin（TM）and Vascular Endothelial-Cadherin （VE-Cadherin）levels of patients in two groups before and after medical treatment were detected, and the clinical curative effect and drug adverse reaction （DAR） were compared as well. Results After 8 weeks＇ treatment, the serum vWF, TM and VE-cadherin levels of patients in two groups were obviously decreased than before with different degrees, and the declining rate in strengthened group was much higher than that in ordinary group （P〈O.05）. Meanwhile,the total clinical efficiency in strengthened group （95.56%） was much higher than that in ordi- nary group （82.22%） （X2=4.05, P〈0.05）. 3 （6.67%） and 6 （ 13.33% ） cases of DAR were appeared in ordinary group and strengthened group during treatment with light symptom, and after comparing DAR of patients in two groups, no statis- tical differences were appeared （x2=0.49,P〉0.05）. Conclusion The rosuvastatin intensive lipid-lowering has significant curative effect on ischemic stroke, and can obviously improve the degree of neural function defect with high security, whose mechanism of action may have close effect on reducing serum vWF, TM and VE-cadherin levels, protect and remedy vascular endothelial function and improve the stability of vulnerable plaques.