| 张秋里,吴凤英,王 宇,徐 彬,向宇鹏.不同剂量瑞舒伐他汀钙治疗脑梗死患者的临床疗效及机制研究[J].,2019,19(14):2747-2750 |
| 不同剂量瑞舒伐他汀钙治疗脑梗死患者的临床疗效及机制研究 |
| Clinical Efficacy of Different Doses of Rosuvastatin Calcium in Treatment of Cerebral Infarction and Its Mechanism |
| 投稿时间：2018-11-24 修订日期：2018-12-18 |
| DOI：10.13241/j.cnki.pmb.2019.14.031 |
| 中文关键词: 脑梗死 瑞舒伐他汀钙 不同剂量 疗效 炎性因子 机制 |
| 英文关键词: Cerebral infarction Rosuvastatin calcium Different doses Efficacy Inflammatory factors Mechanism |
| 基金项目:四川省科技厅科研基金项目（2013ZF0268） |
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| 中文摘要: |
| 摘要 目的：探讨不同剂量瑞舒伐他汀钙治疗脑梗死患者的临床疗效，并分析其疗效机制。方法：将2015年2月至2018年2月医院诊治的脑梗死患者84例按随机数字表法分为观察组（42例）及对照组（42例）。所有患者入院后均给予降血压、降血糖、稳定颅内压以及改善微循环等基本治疗，在此基础上，对照组口服瑞舒伐他汀钙10 mg/d，观察组口服瑞舒伐他汀钙20 mg/d，两组疗程均为14 d。比较两组疗效、治疗前后美国国立卫生研究所卒中量表（NIHSS）评分以及日常生活能力量表（Barthel指数）变化，并比较两组血清白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、高迁移率族蛋白-1（HMGB1）和超敏C反应蛋白（hs-CRP）水平，分析血清HMGB1、IL-6、IL-8和hs-CRP之间的相关性，记录两组患者治疗过程中不良反应发生情况。结果：观察组治疗总有效率为95.24%（40/42），明显高于对照组的80.95%（34/42）（P<0.05）。两组治疗后NIHSS评分均低于治疗前，Barthel指数高于治疗前，同时，观察组NIHSS评分降低程度大于对照组，Barthel指数升高程度大于对照组（P<0.05）。治疗后两组患者血清IL-6、IL-8、HMGB1、hs-CRP明显降低，且观察组血清IL-6、IL-8、HMGB1、hs-CRP明显低于对照组（P<0.05）。Person相关性分析表明患者血清HMGB1与IL-6、IL-8、hs-CRP呈正相关（r=0.306，0.428，0.367，均P<0.05），IL-6与IL-8、hs-CRP呈正相关（r=0.327，0.385，P<0.05），IL-8与hs-CRP亦呈正相关（r=0.430，P<0.05）。治疗期间两组不良反应发生率比较无统计学差异（P>0.05）。结论：高剂量瑞舒伐他汀钙治疗脑梗死能够促进神经功能恢复，提高日常生活能力，临床疗效显著，其机制可能与降低脑梗死急性期炎症反应有关。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical efficacy of different doses of rosuvastatin calcium in the treatment of cerebral infarction, and to analyze the mechanism of its efficacy. Methods: A total of 84 patients with cerebral infarction, who were treated in Sichuan Provincial Corps Hospital of Chinese Armed Police Force from February 2015 to February 2018, were randomly divided into observation group(n=42) and control group (n=42). All patients were given basic treatment, such as lowering blood pressure, lowering blood sugar, stabilizing intracranial pressure and improving microcirculation after admission. On the basis of the therapy, the control group was treated with rosuvastatin calcium with 10 mg/d, and the observation group was treated with rosuvastatin calcium with 20 mg/d,the course of treatment of two groups was 14 days. The therapeutic effect, changes in the National Institutes of Health Stroke Scale (NIHSS) and activity of daily living scale (Barthel Index) before and after treatment, the levels of serum interleukin-6 (IL-6), interleukin-8 (IL-8), high mobility group protein-1 (HMGB1) and hypersensitivity C reactive protein (hs-CRP) of the two groups were compared. The correlation among serum HMGB1 and IL-6, IL-8 and hs-CRP was analyzed. The occurrence of adverse reactions in the two groups was recorded. Results: The total effective rate[95.24% (40/42)] of the observation group was significantly higher than that[80.95%(34/42)] of the control group (P<0.05). After treatment, the NIHSS scores of the two groups were significantly decreased, the Barthel index was significantly increased, and the degree of reduction of the NIHSS score of the observation group was greater than that of the control group, the degree of increase of Barthel index in the observation group was greater than that of the control group (P<0.05). The levels of serum IL-6, IL-8, HMGB1, hs-CRP in the two groups were significantly decrease, the levels of serum IL-6, IL-8, HMGB1 and hs-CRP in the observation group were significantly lower than those in the control group (P<0.05). Person correlation analysis showed that serum HMGB1 was positively correlated with IL-6, IL-8, hs-CRP (r=0.306, 0.428, 0.367, P<0.05); IL-6 was positively correlated with IL-8 and hs-CRP (r=0.327, 0.385, P<0.05); there was also a positive correlation between IL-8 and hs-CRP (r=0.430, P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups during treatment (P>0.05). Conclusion: In the treatment of patients with cerebral infarction, high dose of rosuvastatin calcium can promote the recovery of nerve function and improve the daily living ability, with good clinical effect. Its mechanism may be related to the reduction of the acute inflammatory reaction in the cerebral infarction. |
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