本文關鍵詞：阿托伐他汀鈣對腦梗死急性期患者血清IL-1β、IL-6及TNF-α的表達及神經(jīng)功能的影響，由筆耕文化傳播整理發(fā)布。

        目的：通過檢測腦梗死急性期患者使用阿托伐他汀鈣后不同時期血清白介素-1β、白介素-6及腫瘤壞死因子-α蛋白水平的表達變化及神經(jīng)功能缺損的康復情況，探討他汀類藥物對急性腦梗死炎性損傷機制的干預效果為他汀類藥物用于急性腦梗死患者早期規(guī)范化治療提供有價值的臨床依據(jù)。方法：(1)選擇住院確診為急性腦梗死的患者60例，按照隨機對照原則，依照患者住院順序，將60例病人隨機分成2組，常規(guī)治療組、實驗組（常規(guī)治療加阿托伐他汀鈣治療組）；選擇健康體檢者30例作為正常對照組。(2)常規(guī)治療組治療方案為血小板抑制劑（阿司匹林腸溶片0.1qd，，睡前口服）、腦保護劑及改善腦循環(huán)藥物；實驗組（常規(guī)治療加阿托伐他汀鈣治療組）治療方案為:常規(guī)組治療方案加阿托伐他汀鈣治療(阿托伐他汀鈣片20m qd，睡前口服)。治療組于治療前、治療后第7天、第14天分別抽取空腹12小時后清晨靜脈血采用酶標記免疫吸附測定法(ELISA)檢測血清白介素-1β、白介素-6、腫瘤壞死因子-α；正常對照組僅檢測上述指標1次。(3)應用美國國立衛(wèi)生研究院卒中量表(NIHSS)對入選患者治療前及治療后神經(jīng)功能缺損程度進行評分及日常生活能力量表Barthel指數(shù)（BI）進行評分。并結合性別、年齡等因素加以綜合分析。結果：1、常規(guī)治療組、阿托伐他汀鈣實驗組兩組臨床資料性別構成、平均年齡、治療前NIHSS評分、BI評分、血清白介素-1β、白介素-6和腫瘤壞死因子-a水平比較，無顯著性差異(P＞0.05)。2、與正常組比較，治療前兩組患者血清IL-1β、IL-6和TNF-α水平升高(P＜0.01)。3、（1）治療后7天,常規(guī)治療組及阿托伐他汀治療組兩組患者血清白介素-1β、白介素-6和腫瘤壞死因子-α均較治療前明顯下降(P＜0.05)，且阿托伐他汀鈣組比對照組下降更明顯(P＜0.05)。（2）治療后7天,血清IL-1β、IL-6和TNF-α水平較治療前明顯下降(P＜0.05),且阿托伐他汀鈣組比對照組下降更明顯(P＜0.05)。（3）治療后2周,兩組患者神經(jīng)功能缺損評分均較治療前明顯下降(P＜0.05),阿托伐他汀鈣組比對照組有顯著性差異(P＜0.05)。結論：腦梗死急性期患者應用阿托伐他汀鈣可以使血清IL-1β、IL-6、TNF-α蛋白水平降低；神經(jīng)功能缺損癥狀得到明顯改善。

    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.

阿托伐他汀鈣對腦梗死急性期患者血清IL-1β、IL-6及TNF-α的表達及神經(jīng)功能的影響

摘要4-6Abstract6-7前言8-9資料與方法9-15結果15-20討論20-27結論27-28參考文獻28-32附表 132-36附表 236-44綜述44-53    參考文獻49-53致謝53

  本文關鍵詞：阿托伐他汀鈣對腦梗死急性期患者血清IL-1β、IL-6及TNF-α的表達及神經(jīng)功能的影響，由筆耕文化傳播整理發(fā)布。