不同剂量阿托伐他汀对动脉粥样硬化型脑梗死的疗效及血清炎症因子的影响

Effects of different dosages atorvastatin on atherosclerotic cerebral infarction and serum inflammatory cytokines

目的探讨不同剂量阿托伐他汀对动脉粥样硬化型脑梗死患者的治疗效果及血清炎症指标的影响。方法选取广州中医药大学顺德医院2016年1月至2017年6月收治的80例诊断为动脉粥样硬化型脑梗死患者作为研究对象,根据治疗方案不同将其分为观察组和对照组。将使用阿托伐他汀治疗剂量为每天20 mg患者作为观察组(n=42),使用阿托伐他汀治疗剂量为每天10 mg患者作为对照组(n=38),比较两组患者治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、颈总动脉内中膜厚度(IMT)、血脂水平、干扰素-γ(Interferon-γ,IFN-γ)、白细胞介素-6(IL-6)、Endocan及治疗期间不良反应发生情况。结果观察组患者治疗前NIHSS评分、IMT、血脂、血清炎症指标、Endocan和对照组比较差异均无统计学意义(均P>0.05),两组患者治疗后NIHSS评分、IMT、总胆固醇、三酰甘油、低密度脂蛋白胆固醇和血清IFN-γ、IL-6、Endocan水平均低于治疗前,且观察组患者治疗后NIHSS评分、IMT、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、IFN-γ、IL-6和Endocan水平均显著低于对照组,差异均有统计学意义(均P<0.05)。结论阿托伐他汀对动脉粥样硬化型脑梗死患者神经功能改善有一定促进作用,能有效抑制机体炎症反应,且每天服用20 mg的阿托伐他汀的疗效优于10 mg。

Objective To investigate the effect of different dosages atorvastatin on the therapeutic effect and peripheral inflammation in patients with atherosclerotic cerebral infarction in order to provide reference for clinical treatment.Methods The clinical data of 80 patients with atherosclerotic cerebral infarction diagnosed from January2016 to June 2017 in Shun De Hospital of Guang Zhou University of Chinese Medicine were selected.The patients were divided into observation group and control group according to the treatment plan.Patients receiving atorvastatin treatment at a dose of 20 mg/d were included in the observation group（n=42）,patients treated with atorvastatin at a dose of 10 mg/d were included in the control group（n=38）,and the two groups were observed and compared.Before and after treatment,NIHSS scale scores and IMT were performed;the levels of serum lipids,serum IFN-γ,IL-6,and Endocan levels before and after treatment were analyzed and compared.The levels of NIHSS scores,IMT,and serum IFN-γand IL-6 levels after treatment with atorvastatin were analyzed in the two groups.The incidence of adverse reactions during treatment was compared between the two groups.Results There was no significant difference in NIHSS score,IMT,blood lipid,serum inflammation index,Endocan and control group before treatment in the observation group（P〉0.05）.The level of NIHSS,IMT,total cholesterol,three glycerol,low density lipoprotein cholesterol and serum IFN-gamma,IL-6 and Endocan in the two groups were lower than those of the treatment group.Before and after treatment,the levels of NIHSS,IMT,total cholesterol,three acylglycerol,low density lipoprotein cholesterol,IFN-gamma,IL-6 and Endocan were significantly lower than those in the control group,and the difference was statistically significant（P〉0.05）.Conclusions Atorvastatin can improve the neurological function of patients with atherosclerotic cerebral infarction,and can inhibit the inflammatory reaction of the body,and the efficacy of atorvastatin for 20 mg/d was superior to 10 mg/d.