瑞舒伐他汀对急性缺血性脑卒中患者的免疫调节作用

目的 观察瑞舒伐他汀对急性缺血性脑卒中(AIS)患者的免疫调节作用,并分析了其临床疗效.方法 收集笔者医院2013年3月~2015年2月神经内科收治的AIS患者128例,常规治疗对照组和瑞舒伐他汀治疗观察组,每组64例.比较两组治疗前后TC、TG、LDL-C和HDL-C血脂指标,Th17细胞和Treg细胞,IL-17、IL-10和IL-6炎性因子,以及NIHSS和ADL评分的变化.结果 两组TC、TG、LDL-C和HDL-C血脂指标治疗前差异无统计学意义(P>0.05),治疗后对照组上述血脂指标差异无统计学意义(P>0.05),而观察组TC、TG和LDL-C表达减低(P<0.05和P<0.01),HDL-C表达升高(P<0.05).两组Th17细胞和Treg细胞比例治疗前差异无统计学意义(P>0.05),治疗后两组Th17细胞比例减低和Treg细胞比例升高(P<0.05和P<0.01),但观察组Th17细胞减低的幅度和Treg细胞升高的幅度大于对照组(P<0.05).两组IL-17、IL-10和IL-6表达治疗前差异无统计学意义(P>0.05),治疗后两组IL-17和IL-6达减低而IL-10表达升高(P<0.05和P<0.01),但观察组IL-17和IL-6减低的幅度和IL-10升高的幅度大于对照组(P<0.05).两组NIHSS和ADL评分治疗前差异无统计学意义(P>0.05),治疗后两组NIHSS评分显著减低和ADL评分显著升高(P<0.05和P<0.01),但观察组NIHSS评分减低的幅度和ADL评分升高的幅度大于对照组(P<0.05).对照组临床治疗不良反应率为9.4%,治疗组临床治疗不良反应率为10.9%,两组间差异无统计学意义(P>0.05).结论 瑞舒伐他汀可以调节AIS患者Th17/Treg细胞平衡,抑制炎性反应,临床使用安全,疗效显著,具有一定的临床应用价值.

Immune Modulation of Rosuvastatin on Patients with Acute Ischemic Stroke.

Objective To detect the immune modulation of rosuvastatin on patients with acute ischemic stroke(AIS) and explore its clinical efficacy. Methods A total of 128 AIS patients were enrolled in this study. Patients were randomly divided into: control group(n=64) and rosuvastatin observation group(n=64). The TC, TG, LDL-C, HDL-C, Th17 and Treg cells, IL-17, IL-10, IL-6, NIHSS and ADL scores were compared. Results After treatment, TC, TG, and LDL-C expression were decreased (P<0.05 and P<0.01)and HDL-C expression were increased(P<0.05) in observation group. The improvement of Th17 cells, Treg cells, IL-17, IL-10, IL-6, NIHSS and ADL scores were better in observation group than that in control group (P<0.05). The rate of adverse reaction was 9.4% in control group and 10.9% in treatment group.There was no significant difference of between the two groups (P>0.05). Conclusion Rosuvastatin could regulate Th17/Treg cells immune balance and inhibit inflammatory reaction in AIS patients, with significantly clinical effect and safety.