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| Effect of atorvastatin calcium on serum GFAP, TNF-α, NSE levels and nerve function in the treatment of acute stroke |
| Zhang Dong-lan, Cao Li-ping, Huang Yuan, Shao Yong |
| Department of Encephalopathy, the First Affiliated Hospital, Guizhou University of Traditional Chinese Medicine, Guiyang 550001, China |
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Abstract 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-α level 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-1 β in the observation group was significantly lower than that in the control group ［(13.24±1.77) pg/mL vs. (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 S100β in the observation group were significantly lower than those in the control group ［NSE: (14.25±2.03) ng/mL vs. (23.13±3.24) ng/mL; GFAP: (4.26±0.58) ng/mL vs. (7.56±1.07) ng/mL; S100β: (20.96±2.57) ng/L vs. (27.13±3.09) ng/L］, the difference was statistically significant (P＜0.05). The NIHSS 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 significantly higher than those in the control group after treatment ［BI score: (61.16±8.34) vs. (52.14±7.05); FMA score: (48.12±6.11) vs. (36.56±5.22)］. After treatment, the expression of caspase-3 mRNA(0.37±0.06) and Bax mRNA (0.42±0.68) in the observation group was significantly lower than that in the control group, and the mRNA expression of Bcl-2 (2.91±0.68) was significantly higher than that of the control group (P＜0.05). Conclusion Atorvastatin calcium can reduce serum GFAP, TNF-α, NSE levels in patients with acute stroke, inhibit apoptosis of brain cells, improve neurological function, and the curative effect is remarkable.
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| About author:: Zhang Dong-lan, E-mail: 498213236@126.com |
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| ［1］闫丽, 经屏. 替罗非班治疗急性缺血性脑卒中的临床疗效及其对神经功能和血小板功能的影响［J］. 实用心脑肺血管病杂志,2018, 26(11):103-105.
［2］焦艳, 李喆, 张媛媛, 等. 六君子汤合半夏白术天麻汤化裁对急性缺血性脑卒中患者BDNF、VEGF、MMP-9水平的影响［J］. 辽宁中医杂志, 2018, 45(12):2561-2564.
［3］孟海兰. 神经元可溶性FasL介导缺血性脑卒中后M1型小胶质细胞极化及机制研究［D］.江苏：南京大学, 2016.
［4］董智强, 过岚, 洪媛, 等. 复方麝香注射液联合尤瑞克林治疗急性脑梗死的临床研究［J］.现代药物与临床, 2018, 33(12):3128-3132.［5］董贞.尤瑞克林对急性脑梗死尿激酶静脉溶栓患者血清NSE和MMP-9的影响［J］.河北医药, 2018, 40(24):3763-3766.
［6］李江, 陈信. 阿托伐他汀对动脉硬化性脑梗死患者神经功能及日常生活能力的影响［J］.实用临床医药杂志, 2018, 22(24): 87-89,93.［7］宋文明, 黎永仙, 林智君, 等. 强化他汀联合阿替普酶治疗急性脑梗死的临床观察［J］.临床急诊杂志, 2018, 19(11):787-791.
［8］中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010［J］. 中华神经科杂志, 2010, 43(2):146-153.
［9］Dunning K. National institutes of health stroke scale［J］. Encyclopedia of Clinical Neuropsychology, 2011， 9(1):1714-1715.
［10］蔡业峰, 贾真, 张新春, 等. 美国国立卫生院卒中量表(NIHSS)中文版多中心测评研究-附537例缺血中风多中心多时点临床测评研究［J］.北京中医药大学学报, 2008, 31(7): 494-498.
［11］刘春海，周俊山，施洪超，等. 阿替普酶静脉溶栓治疗急性缺血性脑卒中后出血性转化的影响因素分析［J］. 中国神经免疫学和神经病学杂志， 2018， 25（3）：40-44.
［12］庞国勋, 靳会欣, 刘洪涛. 脑卒中患者MTHFR基因多态性与同型半胱氨酸水平的关系研究［J］. 解放军医药杂志, 2018, 30(12):98-100.
［13］李玉雄, 郭子运, 张雄新. 脑卒中后抑郁患者的炎性因子和脑源性神经营养因子水平变化及相关性分析［J］. 解放军医药杂志, 2018,30(12): 101-104.
［14］范丽桢, 陶文渊, 张曦, 等. 小胶质细胞对缺血性脑卒中的双重作用［J］.中国药理学与毒理学杂志, 2017, 31(12):1169-1176.
［15］周锦霞. 重组组织型纤溶酶原激活剂急诊溶栓联合丹红注射液对急性脑梗死患者神经功能缺损程度评分和Barthel评分的影响［J］.解放军预防医学杂志, 2018, 36(12):1574-1577.
［16］孟祥武, 李青, 陈娟, 等. 急性脑梗死患者血清MMP-9、IGF-1及klotho蛋白与颈动脉粥样硬化程度的关系［J］.中国老年学杂志, 2018, 38(24): 5907-5909.
［17］李迎, 王佩, 柴美静, 等. 黄连素联合阿托伐他汀对AIS病人血清MIF、MONO%及动脉硬化程度的影响［J］. 中西医结合心脑血管病杂志, 2017, 15(23):3058-3061.
［18］史雪霞，马骧，冶学兰.强化抗血小板与他汀类药物在缺血性脑卒中复发高危患者二级预防的对比［J］.实用临床医学杂志， 2018， 22（21）：1-4，8.
［19］纪利利，李美杰，姚丽娜，等.不同剂量阿托伐他汀钙片对急性脑梗死病人血脂代谢、动脉粥样硬化及炎性因子的影响［J］.中西医结合心脑血管病杂志， 2018， 16（18）：2714-2716.
［20］陈杰，赵华平.血栓通联合阿托伐他汀、波立维对合并高血脂急性脑梗死患者血小板聚集、脂代谢和颈动脉粥样硬化斑化的影响［J］.血栓与止血学， 2018， 24（5）：817-820.
［21］Amarenco P， Bogousslavsky I， Challahan A, et al. High-dose atonvastation after stroke or transieut ischemic attack［J］. N Engl J Med, 2006, 355(6):549-559.
［22］郑修广，张作文.不同剂量阿托伐他汀在合并颈动脉不稳定斑块的高龄骨折患者围术期缺血性脑卒中中的治疗效果［J］.中国医药导报， 2018， 15（29）：62-65.
［23］陈肖，胡吉征.阿托伐他汀对老年缺血性脑卒中患者血脂水平的影响［J］.深圳中西医结合杂志， 2018， 29（18）：2880-2882.
［24］郭琳，梁转栓.阿托伐他汀钙对急性脑梗死患者血清hs-CPR、Hcy的影响［J］.现代诊断与治疗， 2018， 29（9）：543-546.
［25］李斐，崔伟佳.阿托伐他汀钙联合阿司匹林对急性缺血性脑卒中患者血清相关细胞因子及神经功能的影响［J］.中国医学工程， 2018， 26（7）：102-104. |
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