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目的观察舟山海岛缺血性脑卒中患者应用辛伐他汀治疗后炎症因子、血小板功能、血脂、颈动脉粥样斑块状态变化。方法98例缺血性脑卒中患者随机分为辛伐他汀20 mg组、40 mg组、对照组三组。分别在用药前及用药后15 d做血常规、炎症因子、血脂、活化血小板检查,在第2天及3个月后,做颈动脉B超。结果C反应蛋白(CRP)在用药两组明显下降,与对照组比较差异有统计学意义(均P<0.05);α-酸性糖蛋白(AAG)及触珠蛋白(HPT)在辛伐他汀40 mg组明显下降,与对照组比较差异有统计学意义(均P<0.05);铜蓝蛋白(CER)三组间差异无统计学意义(P>0.05)。活化血小板(CD62P)在辛伐他汀40 mg组用药后上升幅度明显减小,与其它组比较差异有统计学意义(均P<0.05)。血胆固醇(CHOL)在用药两组明显下降(均P<0.05)。外周血血小板计数(PL)在辛伐他汀40mg组明显下降,与另两组比较差异有统计学意义(均P<0.05)。颈动脉粥样斑块在用药两组治疗3个月后减退,与对照组比较差异有统计学意义(均P<0.05)。结论海岛居民缺血性脑卒中急性期应用辛伐他汀治疗,可出现炎症因子下降、PL降低和CD62P升高幅度减小等作用,辛伐他汀40 mg组作用强于20 mg组,呈现一定的量效关系。并可降低CHOL,在使用3个月后可出现颈动脉粥样斑块减退。
Objective To observe the change of inflammatory factors, platelet function, blood lipid and carotid artery atherosclerotic plaque in patients with ischemic stroke in Zhoushan Island after treatment with simvastatin. Methods 98 patients with ischemic stroke were randomly divided into simvastatin 20 mg group, 40 mg group and control group. Blood samples, inflammatory factors, blood lipids and activated platelets were taken before treatment and 15 days after treatment respectively. Carotid artery B-ultrasound was performed on day 2 and 3 months later. Results C-reactive protein (CRP) was significantly decreased in both groups (P <0.05). Compared with control group, the levels of α-acid glycoprotein (AAG) and haptoglobin (HPT) mg group decreased significantly compared with the control group (all P <0.05); there was no significant difference among the three groups of ceruloplasmin (CER) (P> 0.05). The increase of activated platelet (CD62P) in 40 mg simvastatin group was significantly lower than that in other groups (all P <0.05). Blood cholesterol (CHOL) significantly decreased in both groups (all P <0.05). Peripheral blood platelet count (PL) decreased significantly in Simvastatin 40 mg group compared with the other two groups (all P <0.05). The carotid artery atherosclerotic plaque decreased after 3 months of treatment in both groups, with significant difference compared with the control group (all P <0.05). Conclusion Simvastatin treatment may reduce the inflammatory factor, reduce PL and decrease the increase of CD62P in the ischemic stroke of island residents. Simvastatin 40 mg group is more effective than 20 mg group, showing a certain degree of Quantitative effect relationship. And can reduce CHOL, carotid atherosclerotic plaque may appear after 3 months of use.