瑞舒伐他汀钙通过TLR4/NF-κB信号通路对急性脑梗死患者的疗效及炎症因子的影响  

Effect of rosuvastatin calcium on the efficacy and inflammatory factors of patients with acute cerebral infarction through TLR4/NF-κB signaling pathway

作　　者：胡丹兰 张杰[1] 张美珍[1] HU Danlan;ZHANG Jie;ZHANG Meizhen(Department of Pharmacy,Zhejiang Quhua Hospital,Quzhou 324004,China)

机构地区：[1]浙江衢化医院药剂科,浙江衢州324004

出　　处：《全科医学临床与教育》2020年第11期993-997,共5页Clinical Education of General Practice

基　　金：衢州市科技项目(2019098)。

摘　　要：目的探讨瑞舒伐他汀钙通过Toll样受体4/核转录因子-κB(TLR4/NF-κB)信号通路对急性脑梗死(ACI)患者的临床疗效及对炎症因子的影响。方法将98例ACI患者随机分为低剂量瑞舒伐他汀钙组(Rcl组)和高剂量瑞舒伐他汀钙组(Rch组),每组49例。Rcl组予以瑞舒伐他汀钙10 mg口服,Rch组予以瑞舒伐他汀钙20 mg口服,每日一次,治疗15 d。利用美国国立卫生研究院卒中量表(NIHSS)、神经功能缺损评分量表(CSS)、简易智力状态检查量表(MMSE)和改良Rankin量表(MRS)对两者患者进行评分,测量中层内膜厚度(IMT),检测血清白介素-1β(IL-1β)、白介素-8(IL-8)、人单核细胞趋化蛋白1(MCP-1)和白介素-6(IL-6)的含量,Western blotting检测TLR4、NF-κB和HMGB1蛋白表达量。结果Rch组治疗后NIHSS评分、CSS评分和MRS评分均低于Rcl组治疗后,MMSE评分高于Rcl组治疗后(t分别=3.86、3.49、3.56、-3.26,P均<0.05)。Rch组治疗后左侧IMT、右侧IMT、斑块厚度和斑块面积均低于Rcl组治疗后(t分别=3.12、3.17、3.34、3.66,P均<0.05)。Rch组治疗后IL-1β、IL-8、MCP-1和IL-6均低于Rcl组治疗后(t分别=3.66、3.45、3.57、3.59,P均<0.05)。两组治疗后,Rch组患者的总有效率高于Rcl组,差异有统计学意义(χ^2=4.36,P<0.05)。Rch组HMGB1、TLR4和NF-κB蛋白相对表达量均低于Rcl组,差异均有统计学意义(t分别=3.74、3.53、3.57,P均<0.05)。结论高剂量瑞舒伐他汀钙治疗ACI总有效率高于低剂量瑞舒伐他汀钙,能有效改善ACI动脉粥样硬化和炎症反应,其作用机制可能与TLR4/NF-κB信号通路相关。Objective To investigate the clinical efficacy of rosuvastatin calcium on patients with acute cerebral infarction(ACI)and its influence on inflammatory factors through TLR4/NF-κB signaling pathway.Methods A total of 98 patients with ACI were randomly divided into low-dose rosuvastatin calcium group(Rcl group)and high-dose rosuvastatin calcium group(Rch group),49 cases in each group.The patients in Rcl group were given rosuvastatin calcium 10 mg orally,while the patients in Rch group were given rosuvastatin calcium 20 mg orally,once a day for 15 days.The national institutes of health stroke scale(NIHSS)score,neurological deficit score scale(CSS)score,mini-mental sate examination(MMSE)score,modified rankin scale(MRS)score,the intima-media thickness(IMT),the serum levels of IL-1β,IL-8,IL-6 and MCP-1,TLR4,NF-κB and HMGB1 were compared between two groups.Results After treatment,NIHSS score,CSS score and MRS score of Rch group were lower than those of Rcl group,while MMSE score was higher than that of Rcl group(t=3.86,3.49,3.56,-3.26,P<0.05).After treatment,the IMT of left and right,plaque thickness and plaque area in the Rch group were lower than those in the Rcl group(t=3.12,3.17,3.34,3.66,P<0.05).The levels of IL-1β,IL-8,MCP-1 and IL-6 in the Rch group were lower than those in the Rcl group after treatment(t=3.66,3.45,3.57,3.59,P<0.05).After treatment,the total effective rate of Rch group was higher than that of Rcl group(χ^2=4.36,P<0.05).The relative expression levels of HMGB1,TLR4 and NF-κB in Rch group were lower than those in Rcl group(t=3.74,3.53,3.57,P<0.05).Conclusion The total effective rate of high-dose rosuvastatin calcium in the treatment of ACI is higher than that of low-dose rosuvastatin calcium.It can effectively improve the atherosclerosis and inflammatory reaction of ACI,and its mechanism may be related to TLR4/NF-κB signaling pathway.

关 键 词：急性脑梗死 瑞舒伐他汀钙 TLR4/NF-κB信号通路 炎症因子 

分 类 号：R743.33[医药卫生—神经病学与精神病学]