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

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。

Effects of atorvastatin calcium on serum tumor necrosis factor alpha and C-reactive protein in patients with acute cerebral infarction

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.