西维来司他钠对重症脑卒中患者血乳酸、CRP及TGF-β_(1)的影响研究

Study on effects of sivelestat sodium on serum lactic acid and CRP and TGF-β_(1) in patients with severe stroke

目的研究西维来司他钠对重症脑卒中患者血乳酸、C反应蛋白(CRP)以及转化生长因子β_(1)(TGF-β_(1))的影响。方法42例重症脑卒中患者,随机分为A组(19例)和B组(23例);A组患者接受综合治疗,B组患者在A组基础上加用西维来司他钠治疗。另选取15例轻症脑卒中患者作为C组。比较三组患者血乳酸、CRP及血TGF-β_(1)水平。结果治疗前及治疗2、7 d后,A组血乳酸分别为(2.81±0.96)、(2.23±0.77)、(1.85±0.52)mmol/L,CRP分别为(98.49±5.16)、(56.72±7.72)、(31.22±7.14)mg/L。治疗前及治疗2、7 d后,B组血乳酸分别为(3.08±0.87)、(2.31±0.85)、(1.78±0.63)mmol/L,CRP分别为(95.33±6.11)、(48.74±5.69)、(26.88±5.73)mg/L。C组血乳酸、CRP分别为(2.08±0.52)mmol/L、(18.34±5.88)mg/L。C组血乳酸低于A组和B组治疗前,差异具有统计学意义(P<0.05);C组CRP水平低于A组和B组治疗前及治疗2、7 d后,差异具有统计学意义(P<0.05);但A组和B组治疗前血乳酸、CRP水平比较差异均无统计学意义(P>0.05)。治疗2、7 d后,A组和B组血乳酸、CRP水平均低于本组治疗前,B组CRP水平低于A组,差异具有统计学意义(P<0.05);但A组和B组治疗2、7 d后血乳酸水平比较差异无统计学意义(P>0.05)。治疗前及治疗2、7 d后,A组血TGF-β_(1)分别为(92.16±20.25)、(112.09±35.92)、(183.04±21.22)μg/L,B组血TGF-β_(1)分别为(88.58±22.77)、(168.02±58.16)、(212.13±33.44)μg/L,C组血TGF-β_(1)为(110.25±20.46)μg/L。C组的血TGF-β_(1)水平高于B组和A组治疗前,差异具有统计学意义(P<0.05);A组和B组治疗前血TGF-β_(1)水平比较差异无统计学意义(P>0.05)。治疗2、7 d后,A组和B组血TGF-β_(1)水平均高于本组治疗前,且B组高于A组,差异具有统计学意义(P<0.05)。A组和B组治疗7 d后血TGF-β_(1)水平均高于C组,差异具有统计学意义(P<0.05)。结论西维来司他钠可以降低重症脑卒中患者血乳酸及CRP水平,提高血TGF-β_(1)水平,可改善重症脑卒中患者的预后。

Objective To study the effects of sivelestat sodium on serum lactic acid and C-reactive protein(CRP)and transforming growth factor-β_(1)(TGF-β_(1))in patients with severe stroke.Methods A total of 42 patients with severe stroke were randomly divided into group A(19 cases)and group B(23 cases).Patients in group A received combined treatment,and patients in group B were treated with cilvelestat sodium in addition to group A.Another 15 patients with mild stroke were selected as group C.The levels of serum lactic acid,CRP and TGF-β_(1) were compared among the three groups.Results Before treatment and after 2 and 7 d of treatment,the serum lactic acid in group A were(2.81±0.96),(2.23±0.77)and(1.85±0.52)mmol/L,and CRP were(98.49±5.16),(56.72±7.72)and(31.22±7.14)mg/L,respectively.Before treatment and after 2 and 7 d of treatment,the serum lactic acid in group B were(3.08±0.87),(2.31±0.85)and(1.78±0.63)mmol/L,and CRP were(95.33±6.11),(48.74±5.69)and(26.88±5.73)mg/L,respectively.The serum lactic acid and CRP in group C were(2.08±0.52)mmol/L and(18.34±5.88)mg/L,respectively.The serum lactic acid of group C were lower than those of group A and group B before treatment,and the difference was statistically significant(P<0.05).CRP level of group C was lower than that of group A and group B before treatment and after 2 and 7 d of treatment,and the difference was statistically significant(P<0.05).However,there was no statistically significant difference in serum lactic acid and CRP levels between group A and group B before treatment(P>0.05).After 2 and 7 d of treatment,the serum lactic acid and CRP levels in group A and group B were lower than those before treatment in this group,and CRP level in group B was lower than that in group A.The differences were statistically significant(P<0.05).However,there was no statistically significant difference in serum lactic acid between group A and group B after 2 and 7 d of treatment(P>0.05).Before treatment and after 2 and 7 d of treatment,the serum TGF-β_(1) in group A were(92.16±20.25),(112.09±35.92)and(183.04±21.22)μg/L,the serum TGF-β_(1) in group B were(88.58±22.77),(168.02±58.16)and(212.13±33.44)μg/L.The serum TGF-β_(1) in group C was(110.25±20.46)μg/L.The serum TGF-β_(1) of group C was higher than that of group B and group A before treatment,and the difference was statistically significant(P<0.05).There was no statistically significant difference in serum TGF-β_(1) between group A and group B before treatment(P>0.05).After 2 and 7 d of treatment,the serum TGF-β_(1) in group A and group B was higher than those before treatment in this group,and group B was higher than group A.The differences were statistically significant(P<0.05).The serum TGF-β_(1) in group A and group B after 7 d of treatment was higher than that in group C,and the difference was statistically significant(P<0.05).Conclusion Sivelestat sodium can reduce the level of serum lactic acid and CRP in patients with severe stroke,increase the level of TGF-β_(1) in blood,and improve the prognosis of patients with severe stroke.