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急性脑梗死患者不同剂量阿托伐他汀治疗后血清脂肪因子水平与脑功能恢复的关系研究
宫丽, 曹雄彬, 卢振, 兰艳, 胡智安, 刘雅芳, 孙元平, 邢思思
鄂东医疗集团黄石市中心医院药学部
摘要:
目的探讨急性脑梗死患者不同剂量阿托伐他汀治疗后血清脂肪因子水平与脑功能恢复的关系。方法连续性纳入2014年1月至2016年12月住院治疗的192例急性脑梗死老年患者,按随机数字表法分为阿托伐他汀低剂量组、高剂量组和对照组,每组64例。检测治疗前和治疗后2个月3组患者的血清趋化素、脂联素和丝氨酸蛋白酶抑制剂(vaspin)水平,评价神经功能恢复情况(FMA、NIHSS和Barthel评分),并分析血清脂肪因子波动水平与脑功能程度的关系。结果高剂量组趋化素低于对照组及低剂量组,脂联素、vaspin高于对照组及低剂量组,差异均有统计学意义(均P<0.05)。高剂量组NIHSS评分低于对照组,FMA评分、Barthel评分高于对照组,差异均有统计学意义(均P<0.05)。低剂量组和高剂量组的趋化素、脂联素、vaspin、FMA评分、NIHSS评分、Barthel评分与治疗前比较,差异均有统计学意义(均P<0.05)。高剂量阿托伐他汀与Δvaspin和Δ脂联素呈明显正相关,与Δ趋化素呈明显负相关。3种脂肪因子波动水平和3项评分之间也存在明显相关。结论高剂量阿托伐他汀钙可以改善趋化素、脂联素和vaspin的异常波动,促进神经功能恢复。
关键词:  急性脑梗死 阿托伐他汀 脂肪因子 脑功能恢复
DOI:10.12056/j.issn.1006-2785.2018.40.2.2017-1358
分类号:
基金项目:黄石市医药卫生科技研究项目(2013-47)
Correlation between serum adipocytokines levels and recovery of neural function in patients with acute cerebral infarction following atorvastatin treatment
Edong Healthcare Group Huangshi Central Hospital
Abstract:
Objective To analyze the correlation between serum levels of adipocytokines and recovery of neural function in patients with acute cerebral infarction following atorvastatin treatment. Methods One-hundred and ninety-two patients with acute cerebral infarction (ACI) were divided into three groups randomly with 64 cases in each group: control group, low dose atorvastatin group and high dose atorvastatin group. Serum levels of adipocytokines chemerin, APN and vaspin were measured and neurological scores FMA, NIHSS and Barthel were evaluated before and 2 months after treatment. Results The serum levels of chemerin in high dose atorvastatin group were lower and APN and vaspin were higher than those in control group and low dose atorvastatin group (P<0.05). The NIHSS scores in high dose group was lower, and the FMA and Barthel scores were higher than those in control group (P <0.05). The serum adipocytokines levels and neurological scores in both high dose and low dose atorvastatin groups were improved after treatment (P<0.05). The variation of adipocytokines (Δchemerin, ΔVaspin and ΔAPN) were significantly correlated with the variation of neurological scores (ΔFMA, ΔNIHSS and ΔBarthel). Conclusion Atorvastatin may improve the abnormal fluctuation of adipocytokines chemerin, APN and vaspin and enhance the neural functional recovery in patients with acute cerebral infarction.
Key words:  Acute cerebral infarction Atorvastatin Adipocytokines Neural functional recovery