鞠晓华,张金彪,张海霞

• 1:山东威海市立医院神经内科

摘要(Abstract)：

目的观察瑞舒伐他汀联合普罗布考对急性脑梗死患者血浆超敏C反应蛋白(hs-CRP)及一氧化氮(NO)水平的影响。方法 163例脑梗死急性期患者随机分为4组,A组36例,普通治疗;B组40例,每晚加服瑞舒伐他汀10mg;C组42例,服普罗布考250mg;D组45例,联合服用瑞舒伐他汀和普罗布考,均治疗14d。观察治疗前、治疗后7d、14dhs-CRP、NO的变化等生化指标变化。结果 (1)与治疗前比较,各组治疗后hs-CRP均有下降,差异有统计学意义(P<0.05,P<0.01);B、C、D组hs-CRP下降较A组更明显,差异有统计学意义(P<0.05);治疗后7、14d,D组hs-CRP水平明显低于B、C组,差异有统计学意义(P<0.05)。(2)各组在治疗7d、14dNO较治疗前均有升高,差异有统计学意义(P<0.05);治疗后7d和14d,B、C、D组NO水平高于A组,差异有统计学意义(P<0.05);治疗后14d,D组NO水平明显高于B组、C组,差异有统计学意义(P<0.05)。(3)治疗前hs-CRP与梗死体积显著正相关(r=0.724,P<0.01),与神经功能缺损评分呈正相关(r=0.437,P=0.001)。治疗前NO与梗死体积呈显著负相关(r=-0.797,P<0.01)。结论血浆hs-CRP、NO与急性脑梗死的严重程度密切相关,瑞舒伐他汀、普罗布考能明显降低ACI患者血浆hs-CRP水平,升高NO水平,两药联合应用的疗效优于单药。

关键词(KeyWords)： 瑞舒伐他汀;普罗布考;急性脑梗死;超敏C反应蛋白;一氧化氮

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 鞠晓华,张金彪,张海霞

参考文献(References)：

• [1]Vila N,Castillo J,Davalos A,et al.Proinflammatory cytokinesand early neurological worsening in ischemic stroke[J].Stroke,2000,31:2 325-2 329.
• [2]Stoyanova II,Lazarov NE.Localization of nitric oxide synthasein rat trigeminal primary afferent neurons using NADPH-dia-phorase histochemistry[J].J Mol Histol,2005,36(3):187-193.
• [3]Jantzen F,Knemann S,Wolff B,et al.Isoprinoid depletion bystatins antagonizes cytokine-induced down-regulation of endo-thelial nitric oxide expression and increases NO synthase activi-ty in human umbilical vein endothelial cells[J].J Physiol Phar-macol,2007,58(3):503-514.
• [4]Li W,Asagami T,Matsushita H,et al.Rosuvastatin attenuatesmonocyte-endothelial cell interaction and vascular free radicalproduction in hypercholesterolemic mice[J].J Pharmacol ExpTher,2005,313(2):557-562.
• [5]Anderson TJ,Meredith IT,Yeung AC.The effect of cholester-ol-lowering and antioxidant therapy on endothelium-dependentcoronary vasomotion[J].N Engl J M ed,1995,332(8):488-493.
• [6]Allen CL,Bayraktutan U.Oxidative stress and its role in thepathogenesis of ischaemic stroke[J].Int J Stroke,2009,4(6):461-470.
• [7]Huang PH,Lu TM,Wu TC,et al.Usefulness of combinedhigh-sensitive C-reactive protein and N-terminal-probrain na-triuretic peptide for predicting cardiovascular events in patientswith suspected coronary artery disease[J].Coron Artery Dis,2008,19(3):187-93.
• [8]Song IU,Kim JS,Kim YI,et al.Relationship between high-sen-sitivity C-reactive protein and clinical functional outcome afteracute ischemic stroke in a Korean population[J].CerebrovascDis,2009,28(6):545-550.
• [9]Venugopal SK,Devaraj S,Yuhanna I,et al.De-monstration thatC-reactive protein decreases eNOS expression and bioactivity inhuman aortic endothelial cells[J].Circulation,2002,106:1439-1441.
• [10]Tsuda K.Oxidative stress and membrane fluidity of red bloodcells in hypertensive and normotensive men:an electron spinresonance investigation[J].Int Heart J,2010,51(2):121-124.
• [11]Ballantyne CM,Raichlen JS,Cain VA.Statin therapy altersthe relationship between apolipoprotein B and lowdensity lipo-protein cholesterol and non-high-density lipoprotein cholester-ol targets in high-risk patients:the MERCURYⅡ(Measur-ing Effective Reductions in Cholesterol Using Rosuvastatin)trial[J].J Am Coll Cardiol,2008,52(8):626-632.
• [12]Li W,Asagami T,Matsushita H,et al.Rosuvastatin attenu-ates monocyte-endothelial cell interaction and vascular freeradical production in hypercholesterolemic mice[J].J Pharma-col Exp Ther,2005,313(2):557-562.