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目的观察他汀类药物治疗治疗急性缺血性脑卒中患者循环内皮祖细胞(endothelial progenitor cells,EPCs)数量的影响。方法选取2009年6月-2012年8月我科诊断为急性缺血性脑卒中且在48h内接受治疗的112例患者,随机分为阿托伐他汀组、辛伐他汀组和常规治疗组,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、血脂TC、TG、LDL-C、HDL-C变化。结果治疗后阿托伐他汀组和辛伐他汀组EPCs数量较治疗前有明显改善,差异有统计学意义(P<0.01);治疗后阿托伐他汀组与辛伐他汀组在EPCs数量较常规治疗组有改善,差异有统计学意义(P<0.01)。三组组内NIHSS评分第7d较第1d有改善,差异有统计学意义(P<0.05),第90d较第7d有明显改善,差异有统计学意义(P<0.01);阿托伐他汀组与辛伐他汀组间第90dNIHSS评分较常规治疗组明显改善,差异有统计学意义(P<0.01)。治疗第90d阿托伐他汀组与辛伐他汀组TC、TG、LDL-C及HDL-C均较治疗前有改善,差异有统计学意义(P<0.05或P<0.01);常规治疗组TC、TG、LDL-C及HDL-C无改善,差异无统计学意义(P>0.05)。治疗第90d阿托伐他汀组TC、TG水平低于辛伐他汀组,差异有统计学意义(P<0.05);阿托伐他汀组LDL-C、HDL-C水平与辛伐他汀组比,差异无统计学意义(P>0.05)。结论他汀类药物可以增加EPCs数量并改善患者临床症状,具有保护神经的作用,其保护神经的机制可能为增加EPCs数量、清除动脉粥样硬化斑块及抑制血栓形成。
Objective To observe the effects of statins on the number of circulating endothelial progenitor cells (EPCs) in patients with acute ischemic stroke. Methods One hundred and twelve patients who were diagnosed as acute ischemic stroke in our department from June 2009 to August 2012 and were treated within 48 hours were randomly divided into atorvastatin group, simvastatin group and conventional treatment group. The NIHSS scores, EPCs counts, TC, TG, LDL-C and HDL-C in the three groups before and after treatment were observed. Results After treatment, the number of EPCs in atorvastatin group and simvastatin group was significantly improved compared with those before treatment (P <0.01). After treatment, the number of EPCs in atorvastatin group and simvastatin group was more common The treatment group improved, the difference was statistically significant (P <0.01). The NIHSS score in the three groups improved on the 7th day compared with that on the 1th day, the difference was statistically significant (P <0.05), and significantly improved on the 90th compared with the 7th day (P <0.01). Atorvastatin group Compared with the simvastatin group, the NIHSS score on the 90th day was significantly improved (P <0.01). The levels of TC, TG, LDL-C and HDL-C in atorvastatin group and simvastatin group at 90th day after treatment were significantly improved compared with before treatment (P <0.05 or P <0.01) , TG, LDL-C and HDL-C did not improve, the difference was not statistically significant (P> 0.05). The level of TC and TG in atorvastatin group was lower than that in simvastatin group at 90th day after treatment (P <0.05). The LDL-C and HDL-C levels in atorvastatin group were significantly lower than those in simvastatin group The difference was not statistically significant (P> 0.05). Conclusion Statins can increase the number of EPCs and improve the clinical symptoms of patients with the role of protecting the nerves, the mechanism of neuroprotection may be to increase the number of EPCs, atherosclerotic plaque removal and inhibition of thrombosis.