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阿托伐他汀钙对急性脑梗死患者血清C反应蛋白和肿瘤坏死因子-α的影响
引用本文:刘坤,;宫珍卿,;王永久,;胡新建,;毕仕强,;臧艳平.阿托伐他汀钙对急性脑梗死患者血清C反应蛋白和肿瘤坏死因子-α的影响[J].医师进修杂志,2009(4):15-18.
作者姓名:刘坤  ;宫珍卿  ;王永久  ;胡新建  ;毕仕强  ;臧艳平
作者单位:[1]青岛市第八人民医院神经内科,266100; [2]青岛市第八人民医院麻醉科,266100; [3]青岛市第八人民医院检验科,266100
基金项目:青岛市科技局立项课题(KZD-69)
摘    要:目的观察阿托伐他汀钙对急性脑梗死患者血清C反应蛋白(CRP)和肿瘤坏死因子(TNF)-α水平的影响,探讨阿托伐他汀钙抑制急性脑缺血后炎性损伤的机制。方法选择发病24h内住院的急性脑梗死患者84例,随机分为阿托伐他汀钙治疗组(A组)和常规治疗组(B组),每组各42例。两组均应用抗血小板和改善脑血液循环药物等常规治疗,A组在此基础上口服阿托伐他汀钙20mg/d,连续治疗28d。于治疗前及治疗后3、7d检测两组患者血清CRP和TNF-α水平,并比较两组患者欧洲卒中量表(ESS)评分的差异。另选择同期健康体检者16例作为健康对照组(C组)。结果84例急性脑梗死患者发病后血清TNF—Ot和CRP水平显著升高(P<0.01或<0.05),其中CRP在治疗后3d达高峰,TNF—α在治疗后7d达高峰。A组峰值均低于B组(13.00±2.45)mg/L比(19.21±3.67)mg/L,(19.79±11.01)ng/L比(30.69±18.47).g/L,P<0.05]。治疗后7dA组ESS评分高于B组(79.19±30.59)分比(63.91±27.87)分],差异有统计学意义(P<0.05)。结论阿托伐他汀钙可通过降低血清CRP和TNF—α水平而抑制急性脑缺血后炎性损伤,具有降脂以外的神经保护作用。

关 键 词:肿瘤坏死因子α  C反应蛋白质  脑梗塞  阿托伐他汀钙

Effects of atorvastatin calcium on serum tumor necrosis factor alpha and C-reactive protein in patients with acute cerebral infarction
Institution:LIU Kun, GONG Zhen-qing, WANG Yong-jiu, HU Xin-jian, BI Shi-qiang, ZANG Yah-ping. (Department of Neurology, The Eighth People's Hospital of Qingdao City, Qingdao 266100, China)
Abstract:Objective To observe the effects of atorvastatin calcium on serum tumor necrosis factor alpha (TNF)-α and C-reactive protein (CRP) in patients with acute cerebral infarction (ACI), so as to approach the mechanism of atorvastatin calcium inhibiting ACI inflammatory injury. Methods Eighty-four patients with ACI were randomly divided into 2 groups: group B (42 cases, treated with antiplatelet therapy and improving cerebral circulation), group A(42 cases, treated with atorvastatin calcium 20 mg/d after the onset of ACI for 28 days on the base of group B ). TNF-α and CRP were detected before treatment and in the 3rd,7th day after treatment. The European stroke scale (ESS) was evaluated on the same time. A healthy control group (group C, 16 cases ) was also included in the study. Results The peak of CRP and TNF-α levels were. observed in the 3rd and 7th day after treatment respectively, and the levels of group A were lower than those of group B ( 13.00 ± 2.45 ) mg/L vs ( 19.21 ± 3.67 ) mg/L, ( 19.79 ± 11.01 ) ng/L vs (30.69 ± 18.47 ) ng/L, P 〈 0.05 ]. In the 7th day after treatment, the scores of ESS was higher in group A than that in group B ( 79.19 ± 30.59 ) scores vs ( 63.91 ± 27.87 ) scores, P 〈 0.05 ]. Conclusions Atorvastatin calcium can prevent the increase of serum TNF-α and CRP, and it has anti-inflammatory effect. Atorvastatin calcium may have the role of neuroprotection besides lipid-lowering.
Keywords:Tumor necrosis factor alpha  C-reactive protein  Cerebral infarction  Atorvastatincalcium
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