不同剂量阿托伐他汀治疗对急性脑梗死患者高敏反应蛋白的影响.docVIP

不同剂量阿托伐他汀治疗对急性脑梗死患者高敏C反应蛋白的影响 刘玉梅孙彪张丽娟殷萍李晶鑫魏亚芬 黑龙江省医院150036 R的探讨急性脑梗死患者使用两种剂量(10 mg和20 mg)阿托伐他 汀治疗3天后对血浆高敏C反应蛋白(hsCRP)的变化。方法对确诊为急性脑梗 死的99例患者按随机原则分别入选：常规治疗组(32例)：不接受任何调脂药 物治疗；阿托伐他汀治疗组：分别接受10 mg (31例)和20 mg (36例)阿托伐 他汀治疗3天。并测定各组治疗前后hsCRP和血脂水平的变化。结果治疗3天 后，10 mg阿托伐他汀治疗使血浆hsCRP、水平减低，但与常规治疗组比较差异 无统计学意义；而20 mg治疗组疗效则明显优于常规组，两组间的不降幅度差异 有显著性(Plt; 0.05)o但三组治疗前后各血脂成分的变化差异均无显著性，而 丑20 mg阿托伐他汀治疗引起的血hsCRP的降低与TC, LDL- C的K降百分数之间 无相关性。结论急性脑梗死患者大剂量阿托伐他汀(20 mg)治疗3天后，可明 显降低血浆hsCRP水平及改善内皮功能，从而有利于动脉粥样硬化斑块的稳定性。 关键词：脑梗死；降血脂药；阿托伐他汀；高敏C反应蛋白 Abstract】 Objective To investigate whether intervention with two different dosage of atorvastatin may benefit to plasma levels of high sensitivity C-reactive protein (hsCRP) in patients with acute cerebral infarction.Methods 99 Patients with acute cerebral infarction were randomly assigned into three groups： the control group (n= 32) treated without lipid-lowering drugs，10 mg (n = 31) and 20 mg (n= 36) atorvastatin group with 3 days of treatment.Before and after the treatment, the plasma levels of hsCRP and lipid were detected.Results The treatments of 10 mg atorvastatin did not decrease significantly the levels of hsCRP.Compared to the control group, levels of hsCRP were markedly reduced by 20 mg atorvastatin (Plt;0.05) .No changes of lipid levels were observed in any group before and after treatment, whilst there were no relation between the decreasing percentage of hsCRP and that of TC or LDL-C.Conclusion Treatments with high dose atorvastatin (20 mg) for 3 days could reduce the levels of hsCRP and improved the function of vascular endothelium，which may promotes the stabilization of atherosclerotic plaque. Key words】］Cerebral infarction; Antilipiemic； Atorvastatin； C-reactive protein 动脉粥样硬化(atherosclerosis，AS)是脑梗死(cerebral infarction，Cl)发 生、发展的重要病理生理基础［1】，研究认为脑动脉内粥样硬化斑块的稳定性在 急性脑梗死发病中起决定性作用。而炎症因子介导的内皮功能障碍是引起斑块不 稳定的始动因素，因此改善内皮功能成为脑梗死防治的重点。大量研究己证实他 汀类调脂药具冇改善内皮功能稳定动脉粥样硬化斑块的作用，但短期运用是否冇 类似效果尚不清楚，本研究旨在观察不同剂量的阿托伐他汀治疗3天后对急性脑 梗死患者高敏C反应蛋白(high sensitivity C-rea