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阿托伐他汀钙对急性缺血性脑卒中患者血清GFAPTNF-αNSE及神经功能变化的影响研究

Effect of atorvastatin calcium on serum GFAP,TNF-α,NSE levels and nerve function in the treatment of acute stroke
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摘要 目的探讨阿托伐他汀钙对急性缺血性脑卒中患者血清胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)、肿瘤坏死因子-a(tumor necrosis factor-α,TNF-α)、神经元特异性烯醇化酶(neuron-specific enolase,NSE)及神经功能变化的影响。方法选取贵阳中医学院第一附属医院脑病内科治疗的急性缺血性脑卒中患者82例,按随机数字表法进行对照组和研究组分组,对照组41例予以常规治疗,研究组在对照组基础上予以阿托伐他汀钙片治疗,比较两组患者的治疗总有效率和不良反应发生率,同时比较治疗前后的血清炎症因子[TNF-α、白细胞介素-1β(interleukin-1β,IL-1β)、C-反应蛋白(C-reactive protein,CRP)及白细胞介素-6(interleukin-6,IL-6)]、脑损伤相关蛋白[NSE、GFAP及中枢神经特异蛋白(soluble protein-100g,S100β)]、神经功能评分及半胱氨酸天冬氨酸酶3(caspase-3)、Bcl-2、Bax的mRNA表达水平。结果研究组治疗总有效率(92.68%)明显高于对照组(75.61%),差异有统计学意义(P<0.05)。研究组治疗后血清TNF-α(ng/L:16.23±2.23)明显低于对照组(27.83±3.91),IL-6(pg/mL:7.25±1.03)明显低于对照组(13.12±1.64),IL-1β(pg/mL:13.24±1.77)明显低于对照组(24.16±3.25),CRP(mg/L:3.97±0.55)明显低于对照组(6.76±0.86),差异均有统计学意义(P<0.05);研究组治疗后血清NSE(ng/mL:14.25±2.03)、GFAP(ng/mL:4.26±0.58)、S100β(ng/L:20.96±2.57)均明显低于对照组(23.13±3.24、7.56±1.07、27.13±3.09),差异均有统计学意义(P<0.05)。治疗后研究组美国国立卫生研究院卒中量表(NIHSS)评分(12.45±1.08)明显低于对照组(15.63±2.23),巴特尔日常生活能力指数(BI)评分(61.16±8.34)和Fugl-Meyer运动功能积分法(FMA)评分(48.12±6.11)均明显高于对照组(52.14±7.05、36.56±5.22),caspase-3的mRNA表达量(0.37±0.06)和Bax的mRNA表达量(0.42±1.19)明显低于对照组(0.58±0.09、0.61±0.25),Bcl-2的mRNA表达量(2.91±0.68)明显高于对照组(1.83±0.51),差异� Objective To investigate the effect of atorvastatin calcium on serum glial fibrillary acidic protein(GFAP),tumor necrosis factor-α(TNF-α),neuron-specific enolase(NSE)levels and nerve function in the treatment of acute stroke.Methods A total of 82 cases of acute ischemic stroke treated in nerve department of internal medicine in our hospital were selected and divided into two groups by random number table method.Control group of 41 cases were treated with conventional therapy,and the experiment group were treated with atorvastatin calcium on the base of the control group.Serum inflammatory factor index,brain injury related protein levels,the neurological function score,the clinical efficacy and the occurrence of adverse reactions were compared before and after treatment.Results The effective rate of treatment in the observation group(92.68%)was significantly higher than that in the control group(75.61%),and the difference was statistically significant(P<0.05).Over treatment,the serum TNF-αlevel in the observation group was significantly lower than that in the control group[(16.23±2.23)ng/L vs.(27.83±3.91)ng/L,P<0.05],and the IL-6 level in the observation group was significantly lower than that in the control group[(7.25±1.03)pg/mLvs.(13.12±1.64)pg/mL,P<0.05].The level of IL-1βin the observation group was significantly lower than that in the control group[(13.24±1.77)pg/mLvs.(24.16±3.25)pg/mL,P<0.05].CRP level in the observation group was significantly lower than that in the control group[(3.97±0.55)mg/L vs.(6.76±0.86)pg/mL,P<0.05].The serum levels of NSE,GFAP and S100g in the observation group were significantly lower than those in the control group[NSE:(14.25±2.03)ng/mLvs.(23.13±3.24)ng/mL;GFAP:(4.26±0.58)ng/mLvs.(7.56±1.07)ng/mL;S100B:(20.96±2.57)ng/Lvs.(27.13±3.09)ng/L],the difference was statistically significant(P<0.05).The IHSS score of observation group(12.45±1.08)was significantly lower than that of control group(15.63±2.23).The BI score and the FMA score in the observation group were s
作者 张东兰 曹丽平 黄缓 邵勇 Zhang Dong-lan;Cao Li-ping;Huang Yuan;Shao Yong.(Department of Encephalopathy,the First Afiliated Hospital,Guichou University of Traditional Chinese Medicine,Guiyang 550001,China)
出处 《中国急救医学》 CAS CSCD 北大核心 2019年第5期431-436,共6页 Chinese Journal of Critical Care Medicine
关键词 阿托伐他汀钙 急性脑卒中 胶质纤维酸性蛋白(GFAP) 肿瘤坏死因子-α(TNF-α) 神经元特异性烯醇化酶(NSE) 神经功能 Atorvastatin calcium Acute stroke Glial fibrillary acidic protein(GFAP) Tumor necrosis factor-α(TNF-α) Neuron-specific enolase(NSE) Neurological function
作者简介 张东兰(1978-),女,硕士,主治医师,E-mail:498213236@qq.com。
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