调脂治疗对急性脑梗死患者血清炎性因子水平的影响

目的探讨阿托伐他汀调脂治疗对急性脑梗死患者血清炎性因子水平的影响。方法选择急性脑梗死患者120例,根据颈动脉超声检查结果分为稳定斑块组60例和易损斑块组60例,2组又随机各选30例分别服用阿托伐他汀10mg/晚(小剂量)和阿托伐他汀40 mg/晚(大剂量)治疗。所有患者治疗前和治疗后2周,检测血脂及血清高敏C反应蛋白(hs-CRP)、可溶性细胞间黏附因子1(sICAM-1)、可溶性血管细胞黏附分子1(sVCAM-1)和可溶性CD40配体(sCD40L)及基质金属蛋白酶3(MMP-3)。结果治疗前,易损斑块组sCD40L、sVCAM-1和MMP-3水平明显高于稳定斑块组(P<0.05,P<0.01)。治疗后2周,2组大剂量治疗患者血清LDL-C、hs-CRP、sICAM-1、sVCAM-1、sCD40L和MMP-3水平明显低于小剂量治疗患者(P<0.01)。结论大剂量阿托伐他汀调脂治疗,能降低患者血清炎性因子的水平,具有抑制炎症和稳定斑块作用。

Effect of high-dose atorvastatin on the inflammatory factors in patients with acute cerebral infarction

Objective To observe the effect of short-term high-dose atorvastatin on the inflammatory factors in patients with acute stroke.Methods 120 acute cerebral infarction patients were selected, of whom,60 had carotid vulnerable plaques(group 1) and 60 had carotid stable plaques (group 2).Each group was randomly divided into conventional therapy group(n=60) and highdose atorvastatin group(n = 60).Patients in the conventional therapy group received conventional treatment with low-dose atorvastatin 10 mg daily,whereas patients in high-dose atorvastatin group received atorvastatin 40 mg daily.Blood lipoprotein,high sensitivity C-reactive protein(hs-CRP), soluble intercellular adhesion molecules-1(sICAM-1),soluble vascular cell adhesion molecules-1 (sVCAM-1),soluble CD40L and matrix metalloproteinase-3(MMP-3) were measured in all patients before treatment and two-weeks after drug therapy.Results Before treatment,there were no significant differences in blood lipoprotein,hs-CRP,sICAM-1,sVCAM-1,sCD40L and MMP-3 between the conventional group and high-dose atorvastatin group(P>0.05).There were obviously lower levels of LDL-C,hs-CRP,sICAM-1,sVCAM-1,sCD40L and MMP-3 in patients treated with high-dose atorvastatin for 2 weeks compared with the patients treated with low-dose atorvastatin(P<0.01).Conclusion High-dose atorvastatin could rapidly reduce serum inflammatory factors in patients with acute stroke,thus might inhibit inflammation and stabilize atherosclerotic plaque.