摘要目的 观察阿托伐他汀钙对急性脑梗死患者血清C反应蛋白(CRP)和肿瘤坏死因子(TNF)-α水平的影响,探讨阿托伐他汀钙抑制急性脑缺血后炎性损伤的机制.方法 选择发病24h内住院的急性脑梗死患者84例,随机分为阿托伐他汀钙治疗组(A组)和常规治疗组(B组),每组各42例.两组均应用抗血小板和改善脑血液循环药物等常规治疗,A组在此基础上口服阿托伐他汀钙20 mg/d,连续治疗28 d.于治疗前及治疗后3、7 d检测两组患者血清CRP和,TNF-α水平,并比较两组患者欧洲卒中量表(ESS)评分的差异.另选择同期健康体检者16例作为健康对照组(C组).结果 84例急性脑梗死患者发病后血清TNF-α和CRP水平显著升高(P<0.01或<0.05),其中CRP在治疗后3d达高峰,TNF-α在治疗后7d达高峰.A组峰值均低于B组[(13.00±2.45)mg/L比(19.21±3.67)mg/L,(19.79±11.01)ng/L比(30.69±18.47)ng/L,P<0.05].治疗后7 d A组ESS评分高于B组[(79.19±30.59)分比(63.91±27.87)分],差异有统计学意义(P<0.05).结论 阿托伐他汀钙可通过降低血清CRP和TNF-α水平而抑制急性脑缺血后炎性损伤,具有降脂以外的神经保护作用.

abstractsObjective To observe the effects of atorvastatin calcium on serum tumor necrosis factor alpha (TNF)-α and C-reactive protein (CRP) in patients with acute cerebral infarction (ACI), so as to approach the mechanism of atorvastatin calcium inhibiting ACI inflammatory injury. Methods Eighty-four patients with ACI were randomly divided into 2 groups: group B (42 cases, treated with antiplatelet therapy and improving cerebral circulation), group A(42 cases, treated with atorvastatin calcium 20 mg/d after the onset of ACI for 28 days on the base of group B). TNF- α and CRP were detected before treatment and in the 3rd,7th day after treatment. The European stroke scale (ESS) was evaluated on the same time. A healthy control group (group C, 16 cases) was also included in the study. Results The peak of CRP and TNF-α levels were observed in the 3rd and 7th day after treatment respectively, and the levels of group A were lower than those of group B [(13.00 ± 2.45) mg/L vs (19.21 ± 3.67) mg/L,(19.79 ± 11.01) ng/L vs (30.69 ± 18.47) ng/L, P < 0.05]. In the 7th day after treatment, the scores of ESS was higher in group A than that in group B [(79.19 ± 30.59) scores vs (63.91 ± 27.87) scores, P < 0.05]. Conclusions Atorvastatin calcium can prevent the increase of serum TNF-α and CRP, and it has anti-inflammatory effect. Atorvastatin calcium may have the role of neuroprotection besides lipid-lowering.