阿托伐他汀对椎基底动脉供血不足患者Lp-PLA2和hs-CRP的影响

目的观察阿托伐他汀对椎基底动脉（BA）供血不足患者脂蛋白相关磷脂酶-A2（Lp-PLA2）及超敏C反应蛋白（hs-CRP）的影响。方法选择我科收治的78例BA供血不足患者,随机分为治疗组及对照组,每组39例。对照组给予常规抗凝、活血、改善循环治疗,治疗组在此基础上加用阿托伐他汀（20 mg,1次/d）。在治疗前及治疗后7 d分别查2组血清Lp-PLA2及hs-CRP,经颅多普勒（TCD）评估治疗前后BA收缩期峰流速（Vp）。结果2组治疗前血清Lp-PLA2及hs-CRP水平比较,差异无统计学意义（P〉0.05）,治疗7 d后2组血清Lp-PLA2及hs-CRP水平均较治疗前明显降低（P〈0.05）,且治疗组降低较对照组更为明显,差异有统计学意义（P〈0.05）。治疗组椎动脉（VA）及BA的Vp改善优于对照组,差异有统计学意义（P〈0.05）。结论在改善循环基础上联合阿托伐他汀能改善BA、Vp,其机制可能是通过降低血清Lp-PLA2及hs-CRP水平,从而改善患者血液黏度、增加脑血供水平。

Effect of atorvastatin on the levels of lipoprotein-associated phospholipase A2 and high-sensitivity C-reactive protein in the patients with vertebro-basilar artery insufficiency

Objective To observe the effect of atorvastatin on the level of lipoprotein-associated phospholipase A2（Lp-PLA2） and high-sensitivity C-reactive protein（ hs-CRP） in the patients with vertebro-basilar artery insufficiency（VBI）. Methods Seventy-eight patients with VBI were randomly divided into treatment group and control group,with 39 patients in each group. The control group was given conventional therapy（including anti-freezing, promoting blood circula-tion to remove blood stasis）, and the treatment group received atorvastatin（20 mg,1 time per day）on the basis of conven-tional therapy. The levels of Lp-PLA2 and hs-CRP were determined and ultrasonography doppler transcramal（TCD） detec-tion was performed before treatment and seven days after treatment. The change of vertebro-basilar artery peak systolic ve-locity was eva-luated. Results The levels of Lp-PLA2 and hs-CRP showed no significant difference between two groupsbefore treatment. After treatment, the levels of Lp-PLA2 and hs-CRP were significantly decreased seven days after therapy（P〈0. 05） in both groups,especially in treatment group（P〈0. 05）. The change of the peak systolic velocity of vertebro-basilar artery in treatment group was more significant than that in control group（P〈0. 05）. Conclusions Atorvastatincan improve the symptoms of VBI. The mechanism may be reducing the levels of Lp-PLA2 and hs-CRP,and then improvingblood viscosity,increasing the level of cerebral blood flow.