大剂量阿托伐他汀钙对内囊预警综合征进展为脑梗死患者血清S100B蛋白及预后的影响  

Effect of large dose of atorvastatin on serum S100B protein and prognosis in patients with stroke coming from capsular warning syndrome

作　　者：杨蕾[1] 王宇航[1] 李玉成[1] 裴小溪[1] 李发良[1] 

机构地区：[1]河南省人民医院急救中心,郑州450003

出　　处：《中国实用神经疾病杂志》2013年第4期4-7,共4页Chinese Journal of Practical Nervous Diseases

摘　　要：目的研究血清S100B蛋白及血脂水平与内囊预警综合征病情严重性及预后的关系,探讨阿托伐他汀对内囊预警综合征进展为脑梗死患者血清S100B蛋白水平及预后的影响。方法随机将发病24h内入院的内囊预警综合征进展为脑梗死患者30例分为对照组和阿托伐他汀组(阿托伐他汀80mg/d,连续用药14d)。治疗前后检测血清S100B蛋白、血脂、血清谷草转氨酶(AST)及血清肌酸激酶(CK)水平,应用美国国立卫生研究院卒中量表(NIHSS)及Barthel指数(BI)记分法对入院后当天及3个月时行神经功能缺损程度评分。结果治疗前血清S100B蛋白与当时及3个月时病情严重性显著相关(r=0.721,r=-0.635,P均<0.001;r=0.561,r=-0.623,P均<0.001),血脂水平则无相关性。治疗后阿托伐他汀组血清S100B蛋白水平下降,且与对照组相比,差异有统计学意义(P=0.009)。各组入院时神经功能缺失程度评分与3个月后相比,差异有统计学意义(P<0.001,P<0.001),但不同组之间相比差异无统计学意义(P>0.05)。治疗后各组AST及CK水平无明显变化。结论内囊预警综合征进展为脑梗死患者血清S100B蛋白水平与病情的严重程度及预后相关。短期应用大剂量阿托伐他汀可以降低内囊预警综合征进展为脑梗死,安全性好,但对内囊预警综合征进展为脑梗死后3个月的预后无明显改善作用。阿托伐他汀对内囊预警综合征进展为脑梗死患者的疗效需进一步研究。Objective To study the relationship between serum S100B protein,serum lipids and severity,prognosis of stroke coming from capsular warning syndrome,then to explore the effect of large dose of atorvastatin on S100B protein levels and prognosis.Methods Totally 30 patients with stroke coming from capsular warning syndrome were randomly divided into control group（n=15） and atorvastain group（n=15,80 mg/d of atorvastain for 14 days）.The serum levels of MMP-9,lipids,aspartate aminotransferase（AST） and creatine kinase（CK） were detected before and after treatment.All patients＇ never function were evaluated by the National Institutes of Health Stroke Scale（NIHSS） score and the Barthel Index（BI） score at admission and 3 months after admission.Results The levels of serum S100B protein were significantly correlated with the severity and prognosis of cerebral infarction（r=0.721,r=-0.635,P0.001;r=0.561,r=-0.623,P0.001）,but serum lipids were not correlated.The levels of serum S100B protein in atorvastain group significantly decreased compared with those in control group（P=0.009）.Neurological functional deficit scales in the two groups were significantly improved after 3 months（P0.001,P0.001）,but there was no statistical difference in two groups.AST and CK levels had no changes after treatment.Conclusion The levels of serum S100B protein are associated with the severity and can predict the prognosis in patient with cerebral infarction coming from capsular warning syndrome.Large dose of atorvastain can rapidly and safely reduce the serum level of S 100B protein,but there is no significant improvement in 3-month prognosis.The efficacy of large dose of atorvastain in the treatment of cerebral infarction coming from capsular warning syndrome deserves further study.

关 键 词：内囊预警综合征 阿托伐他汀钙 血清S100B蛋白 

分 类 号：R743.33[医药卫生—神经病学与精神病学]