阿托伐他汀钙对脑梗死急性期患者血清IL-1β、IL-6及TNF-α的表达及神经功能的影响

  本文关键词：阿托伐他汀钙对脑梗死急性期患者血清IL-1β、IL-6及TNF-α的表达及神经功能的影响，由笔耕文化传播整理发布。

        目的：通过检测脑梗死急性期患者使用阿托伐他汀钙后不同时期血清白介素-1β、白介素-6及肿瘤坏死因子-α蛋白水平的表达变化及神经功能缺损的康复情况，探讨他汀类药物对急性脑梗死炎性损伤机制的干预效果为他汀类药物用于急性脑梗死患者早期规范化治疗提供有价值的临床依据。方法：(1)选择住院确诊为急性脑梗死的患者60例，按照随机对照原则，依照患者住院顺序，将60例病人随机分成2组，常规治疗组、实验组（常规治疗加阿托伐他汀钙治疗组）；选择健康体检者30例作为正常对照组。(2)常规治疗组治疗方案为血小板抑制剂（阿司匹林肠溶片0.1qd，，睡前口服）、脑保护剂及改善脑循环药物；实验组（常规治疗加阿托伐他汀钙治疗组）治疗方案为:常规组治疗方案加阿托伐他汀钙治疗(阿托伐他汀钙片20m qd，睡前口服)。治疗组于治疗前、治疗后第7天、第14天分别抽取空腹12小时后清晨静脉血采用酶标记免疫吸附测定法(ELISA)检测血清白介素-1β、白介素-6、肿瘤坏死因子-α；正常对照组仅检测上述指标1次。(3)应用美国国立卫生研究院卒中量表(NIHSS)对入选患者治疗前及治疗后神经功能缺损程度进行评分及日常生活能力量表Barthel指数（BI）进行评分。并结合性别、年龄等因素加以综合分析。结果：1、常规治疗组、阿托伐他汀钙实验组两组临床资料性别构成、平均年龄、治疗前NIHSS评分、BI评分、血清白介素-1β、白介素-6和肿瘤坏死因子-a水平比较，无显著性差异(P＞0.05)。2、与正常组比较，治疗前两组患者血清IL-1β、IL-6和TNF-α水平升高(P＜0.01)。3、（1）治疗后7天,常规治疗组及阿托伐他汀治疗组两组患者血清白介素-1β、白介素-6和肿瘤坏死因子-α均较治疗前明显下降(P＜0.05)，且阿托伐他汀钙组比对照组下降更明显(P＜0.05)。（2）治疗后7天,血清IL-1β、IL-6和TNF-α水平较治疗前明显下降(P＜0.05),且阿托伐他汀钙组比对照组下降更明显(P＜0.05)。（3）治疗后2周,两组患者神经功能缺损评分均较治疗前明显下降(P＜0.05),阿托伐他汀钙组比对照组有显著性差异(P＜0.05)。结论：脑梗死急性期患者应用阿托伐他汀钙可以使血清IL-1β、IL-6、TNF-α蛋白水平降低；神经功能缺损症状得到明显改善。

    Objective:Through study atorvastain in treatment of ischemic stroke and observe thelevels of serum IL-1β, IL-6, TNF-αprotein and the neurologicalfunction on different phases, explore the intervention effect of statinson the mechanism of acute cerebral infarction inflammatory injury. Toprovide valuable evidence for standard therapy for patients with acutecerebral infarction early on the use of statins.Methods:(1)60patients with acute cerebral infarction, randomly divided intoroutine group and treatment group by the patient’s treatment sequence.30healthy cases as the normal control group.(2) Routine group: the conventional treatment including resistingplatelet aggregation (aspirin0.1qn), brain protecting agent andimproving brain circulation. Treatment group: adding atorvastatin(atorvastatin20mg qn) to the conventional treatment.Vein blood samplecollected before breakfast on the morning before therapy and the firstweek, the second week after therapy. IL-1β, IL-6, TNF-αwere testedby ELISA. At the same time, the normal samples were collected once.(3) The neurological function for all subject were evaluated by the U.S.National Institutes of Health Stroke amount (NIHSS) and daily livingscale Barthel index(BI)score before and after therapy. Results:1. Compare routine group with treatment group. The gender composition,average age, the NIHSS score and the levels of serum IL-1β, IL-6, TNF-α have no significant differences (P>0.05).2. Before treatment, the levels of serum IL-1β, IL-6, TNF-α in thetwo experimental groups is higher than the normal control group(P <0.01).3.(1) After one week, compared with the untreated, the level of serumIL-1β, IL-6and TNF-αdecreased significantly (P <0.05), while thetreatment group decreased more significantly (P <0.05).(2) After twoweeks, the levels decreased significantly than before therapy (P <0.05),and the treatment group decreased more significantly than the normalcontrol group (P <0.05).(3) After two weeks of treatment, the score ofNIHSS is lower than before treatment, in the two experimental groups (P<0.05), the treatment group decreased significantly than the normalcontrol group (P＜0.05).Conclusion: With astorvastain treatment of acute cerebral infarction,the level of serum IL-1β, IL-6and TNF-α will be decreasedsignificantly and the neurological function will be improved.

阿托伐他汀钙对脑梗死急性期患者血清IL-1β、IL-6及TNF-α的表达及神经功能的影响

摘要4-6Abstract6-7前言8-9资料与方法9-15结果15-20讨论20-27结论27-28参考文献28-32附表 132-36附表 236-44综述44-53    参考文献49-53致谢53

  本文关键词：阿托伐他汀钙对脑梗死急性期患者血清IL-1β、IL-6及TNF-α的表达及神经功能的影响，由笔耕文化传播整理发布。