CAJ | 학술논문

目的：观察不同剂量阿托伐他汀对急性脑梗死患者超敏C反应蛋白(hs-CRP)、S100B水平及神经功能的影响,探索大剂量阿托伐他汀对脑梗死急性期治疗的益处。方法选择急性脑梗死患者96例,随机分为治疗组与对照Ⅰ组、对照Ⅱ组。治疗组服用阿托伐他汀40 mg/d,对照Ⅰ组服用阿托伐他汀20 mg/d,对照Ⅱ组服用阿托伐他汀10 mg/d,其余治疗均相同。分别于治疗前及治疗7、14 d后检测患者血清 hs-CRP和S100B水平,评价神经功能缺损程度。结果治疗7 d后,治疗组 hs-CRP水平明显下降(P<0．05),对照Ⅰ、Ⅱ组hs-CRP水平下降均不明显(P>0．05)。治疗组S100B水平较治疗前显著下降(P<0．05),对照Ⅰ、Ⅱ组S100B水平变化不明显(P>0．05)。治疗14 d后,治疗组hs-CRP水平进一步下降(P<0．05),对照Ⅰ、Ⅱ组血清hs-CRP水平有明显下降(P<0．05)。治疗组S100B水平进一步下降(P<0．05),对照Ⅰ组S100B水平较治疗前明显下降(P<0．05),对照Ⅱ组S100B水平变化不明显(P>0．05)。治疗后,3组神经功能缺损情况均较治疗前有不同程度改善(P<0．05),与对照组相比治疗组改善更明显。结论相对20 mg/d、10 mg/d的阿托伐他汀治疗急性脑梗死,40 mg/d的剂量可更明显降低hs-CRP、S100B蛋白水平,改善患者的神经功能缺损,有益于改善患者预后。
목적：관찰불동제량아탁벌타정대급성뇌경사환자초민C반응단백(hs-CRP)、S100B수평급신경공능적영향,탐색대제량아탁벌타정대뇌경사급성기치료적익처。방법선택급성뇌경사환자96례,수궤분위치료조여대조Ⅰ조、대조Ⅱ조。치료조복용아탁벌타정40 mg/d,대조Ⅰ조복용아탁벌타정20 mg/d,대조Ⅱ조복용아탁벌타정10 mg/d,기여치료균상동。분별우치료전급치료7、14 d후검측환자혈청 hs-CRP화S100B수평,평개신경공능결손정도。결과치료7 d후,치료조 hs-CRP수평명현하강(P<0．05),대조Ⅰ、Ⅱ조hs-CRP수평하강균불명현(P>0．05)。치료조S100B수평교치료전현저하강(P<0．05),대조Ⅰ、Ⅱ조S100B수평변화불명현(P>0．05)。치료14 d후,치료조hs-CRP수평진일보하강(P<0．05),대조Ⅰ、Ⅱ조혈청hs-CRP수평유명현하강(P<0．05)。치료조S100B수평진일보하강(P<0．05),대조Ⅰ조S100B수평교치료전명현하강(P<0．05),대조Ⅱ조S100B수평변화불명현(P>0．05)。치료후,3조신경공능결손정황균교치료전유불동정도개선(P<0．05),여대조조상비치료조개선경명현。결론상대20 mg/d、10 mg/d적아탁벌타정치료급성뇌경사,40 mg/d적제량가경명현강저hs-CRP、S100B단백수평,개선환자적신경공능결손,유익우개선환자예후。
Objective To investigate the effects of atorvastatin in different dose on serum levels of hs-CRP,S100B protein and the neurological impairment in patients with acute cerebral infarction, so as to explore the benefits of large doses of atorvastatin on acute cerebral infarction. Methods Ninety-six patients with acute cerebral infarction were enrolled and randomized into treatment group, controlⅠgroup and control Ⅱ group. Treatment group received atorvastatin 40 mg/d, controlⅠgroup 20 mg/d, and controlⅡgroup 10 mg/d. The remai-ning treatment of the three groups was the same. The serum levels of hs-CRP,S100B protein and the neurological impairment were evaluated before treatment and 7,14 days after treatment respectively. The measured results were statistically analyzed. Results 7 days after treat-ment, the serum levels of hs-CRP decreased significantly in treatment group (P<0. 05), and hs-CRP levels in controlⅠgroup and controlⅡgroup did not change obviously(P>0. 05). The levels of S100B in treatment group dropped more sharply than that before treatment (P<0. 05), S100B protein levels had no obvious change in controlⅠgroup and controlⅡ group(P>0. 05). 14 days after further treatment, hs-CRP levels decreased further in treatment group (P<0. 05), and the levels of hs-CRP in controlⅠgroup and controlⅡgroup also had obvi-ous decline(P<0. 05). S100B protein levels declined further in treatment group(P<0. 05). The levels of S100B in controlⅠgroup de-creased more significantly than that before treatment (P<0. 05), and it did not change obviously in controlⅡgroup (P>0. 05). The neu-rological impairment was progressively improved in all groups ( P<0. 05 ) , but the improvement was more marked in the treatment group. Conclusion Treatment with 40 mg/d atorvastatin can reduce the levels of hs-CRP and S100B protein more obviously than treated with 20 mg/d and 10 mg/d atorvastatin, and the effect on acute cerebral infarction is better.