摘要
目的 探讨他汀类药物对急性缺血性脑卒中患者循环内皮祖细胞（EPCs）数量的影响.方法 选择2010年6月～2013年6月湖北医药学院附属十堰市太和医院120例确诊急性缺血性脑卒中的患者,将其分为阿托伐他汀组（45例）、辛伐他汀组（41例）及常规治疗组（34例）,观察三组患者治疗前后美国国立卫生研究院卒中量表（NIHSS评分）、EPCs数量、迁移能力和克隆形成能力、血脂总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、血糖、糖化血红蛋白、同型半胱氨酸、肌酐、C反应蛋白的变化.结果 无论是和用药前还是同常规治疗组比较,他汀类药物治疗组循环EPCs数量均明显增加,差异有高度统计学意义（P＜0.01）.三组组内NIHSS评分第6周较治疗前、第12周比第6周有改善（P＜ 0.01）;NIHSS评分在他汀类药物组治疗12周后可见显著改善（P＜0.01）.他汀类药物组治疗组的TC、TG、LDL-C及HDL-C在12周后均可见改善（P＜ 0.05或P＜ 0.01）,而常规治疗组治疗前后血脂相关指标无改善.组间比较,阿托伐他汀组治疗12周后TC、TG水平低于辛伐他汀组,差异有统计学意义（P＜0.05）.而组间及组内血糖、糖化血红蛋白、同型半胱氨酸、肌酐、C反应蛋白差异均无统计学意义（P＞0.05）.结论 他汀类药物可显著提高EPCs数量、迁移能力及克隆形成能力,改善缺血性脑卒中患者血脂相关指标和临床症状,并通过调节血脂、抑制粥样斑块形成等起到减轻神经损伤的作用.
Objective To investigate the effect of statins therapy on circulating endothelial progenitor cells （EPCs） in patients with acute ischemic stroke.Methods 120 patients undergoing acute ischemic stroke within 6 h and hospitalized in Shiyan Taihe Hospital Affiliated to Hubei Medical University from June 2010 to June 2013 were enrolled in a randomized clinical trial,including Atorvastatin group （45 cases）,Simvastatin group （41 cases） and the conventional treatment group （34 cases）.The national institutes of health stroke scale （NIHSS score）,EPCs number,migration and colony forming ability,lipids TC,TG,LDL-C,HDL-C,glucose,glycosylated hemoglobin,homocysteine acid,creatinine,C-reactive protein changes were observed before and after treatment within three groups of patients.Results The circulating EPCs counts were significantly increased in statin treatment group compared with the conventional treatment group （P ＜ 0.01）.As for NIHSS score of all groups,the 12th and 6th week saw a significant improvement compared with the 1st day,so the 12th week compared with 6th week （P ＜ 0.01）;statin treatment group saw a significantly improving compared with conventional treatment group as regard of NIHSS score after 12 weeks （P ＜ 0.01）.TC,TG,LDL-C and HDL-C changed to a better level in statin treatment group after 12 weeks,the difference was statistically significant （P ＜ 0.05 or P ＜ 0.01）,while there was no difference seen in the conventional treatment group before and after treatment as to those lipid-related index.Atorvastatin group had a lower TC,TG levels compared with the Simvastatin group after 12 weeks （P ＜ 0.05）.Blood glucose,glycosylated hemoglobin,homocysteine,creatinine,C-reactive protein were not significantly different from each other in groups （P ＞ 0.05）.Conclusion Statins can significantly increase the number of EPCs,as well as migration and colony forming ability,improving revascularization in ischemic stroke patients and clinical symptoms,leading to neuroprotection by regulating blood lipids,inhibit plaque formation and so on.
出处
《中国医药导报》
CAS
2013年第33期96-100,共5页
China Medical Herald
基金
湖北省自然科学基金计划项目(编号2011CDB131)
