强化降脂治疗对急性脑梗死患者血清mTOR和Tau蛋白水平的影响

Effect of Intensive Lipid-lowering Therapy on Serum mTOR and Tau Protein Levels in Patients with Acute Cerebral Infarction

目的考察强化降脂治疗对急性脑梗死患者血清mTOR和Tau蛋白水平的影响。方法选取2016年5月—2017年5月收治的急性脑梗死患者120例,年龄40~60岁,性别不限,体质量50~80 kg。采用随机数字表法将所有入选患者分为对照组和观察组(n=60)。对照组患者给予常规治疗外口服常规剂量阿托伐他汀每天1次,每次10 mg。观察组在常规治疗外口服强化剂量阿托伐他汀每天1次,每次40 mg。采用双抗体夹心ELISA法测定患者血清mTOR、Tau蛋白表达与NF-κB和IL-6蛋白表达。采用美国国立卫生研究院脑卒中量表(NIHSS)评估患者神经功能缺损情况。结果与对照组比较,观察组患者治疗后各时间点血清mTOR、Tau蛋白、NF-κB和IL-6蛋白含量显著下降(P<0.05),NIHSS评分显著下降(P<0.05)。与治疗前相比,观察组患者治疗后各时间点血清mTOR、Tau蛋白、NF-κB和IL-6蛋白含量显著下降(P<0.05),NIHSS评分显著下降(P<0.05)。结论强化降脂治疗能显著降低急性脑梗死患者炎症反应,提高易损斑块的稳定性,其机制与降低患者血清mTOR和Tau蛋白水平有关。

OBJECTIVE To investigate the effect of intensive lipid-lowering therapy on serum mTOR and Tau levels in patients with acute cerebral infarction. METHODS One hundred and twenty patients aged 40-60 years old, weighing 50-80 kg with acute cerebral infarction were randomly divided into 2 groups（n=60 each group）： control group, intensive lipid-lowering therapy group. The control group were treated with conventional treatment and atorvastatin（10 mg·d^-1, qd）. The intensive lipid-lowering therapy group were treated with conventional treatment and atorvastatin（40 mg·d^-1, qd）. Venous blood samples were obtained for determination mTOR, Tau, NF-κB and IL-6 concentrations by ELISA. NIHSS scale were performed to evaluate the neurdogical deficit in patients. RESULTS Compared with control group, the serum mTOR, Tau, NF-κB, IL-6 and NIHSS score of intensive lipid-lowering therapy group were significantly lower（P〈0.05）. Compared with before treatment, the serum mTOR, Tau, NF-κB, IL-6 and NIHSS score of intensive lipid-lowering therapy group were significantly lower after treatment（P〈0.05）. CONCLUSION Intensive lipid-lowering can reduce inflammatory response in patients with acute cerebral infarction, and improve the stability of vulnerable plaque. The possible mechanism may be related to reduce the concentration of serum mTOR and Tau.