他汀类药物对房颤相关性急性缺血性脑卒中患者血浆Ox-LDL水平的影响及预后研究  

Effects of statins on plasma Ox-LDL levels and prognosis in patients with acute ischemic stroke associated with atrial fibrillation

作　　者：黎凯锋 田灿辉 潘俊安 梁土金 LI Kaifeng;TIAN Canhui;PAN Junan;LIANG Tujin(Internal Medicine-Neurology,Shenzhen Hospital of Southern Medical University,Shenzhen,Guandong,518101,China;Internal Medicine-Neurology,Liuyang Traditional Chinese Medicine Hospital of Hunan Province;Internal Medicine-Neurology,Huizhou Zhongda Huiya Hospital)

机构地区：[1]南方医科大学深圳医院神经内科,广东深圳518101 [2]湖南省浏阳市中医医院神经内科 [3]惠州市中大惠亚医院神经内科

出　　处：《临床急诊杂志》2020年第12期982-986,共5页Journal of Clinical Emergency

基　　金：深圳市宝安区科技局课题(No:2018JD223);广东省自然科学基金项目(No:2018A030313586)。

摘　　要：目的:探讨他汀类药物治疗对房颤相关性急性缺血性脑卒中患者血浆氧化低密度脂蛋白(Ox-LDL)水平的影响及预后研究。方法:选取南方医科大学深圳医院2017年12月—2019年12月期间神经内科住院收治的房颤相关性急性缺血性脑卒中患者268例,根据卒中前是否使用他汀类药物治疗将患者分为研究组(他汀类药物治疗组,117例)和对照组(未使用他汀类药物,151例),住院期间予以阿托伐他汀治疗,治疗随访观察3个月,临床预后结局根据改良Rankin量表(mRS)分为预后不良组(mRS评分≥3分)和预后良好组(mRS评分<3分)。采用酶联免疫吸附试验(ELISA)测定入院时和出院后3个月时血浆Ox-LDL水平。比较两组间及治疗前后的血浆Ox-LDL水平、NIHSS评分。结果:两组患者在治疗后与治疗前比较,血浆Ox-LDL水平明显降低,研究组血浆Ox-LDL水平明显低于对照组,差异有统计学意义(P<0.05);血浆Ox-LDL水平对临床预后的影响中,预后良好组与预后不良组比较,治疗前后Ox-LDL水平和NIHSS评分明显下降(P<0.05)。结论:应用他汀类药物可降低房颤相关性急性缺血性脑卒患者血浆Ox-LDL水平,改善临床预后,具有重要的临床价值。Objective: To investigate the effects of statins on plasma oxidized low density lipoprotein(Ox-LDL) level in patients with acute ischemic stroke associated with atrial fibrillation and its role on prognosis. Methods: A total of 268 patients with acute ischemic stroke associated with atrial fibrillation who were admitted to the department of neurology in our hospital From December 2017 to December 2019 were selected. 117 patients were in the study group(the statin-treated group) and 151 patients were in the control group(without statins-treated group) based on whether or not they were treated with statins before stroke;Atorvastatin was administered during the hospitalization, and the patients were followed up for 3 months;Clinical prognostic and outcomes according to the modified Rankin scale(mRS), they were divided into the poor prognostic group(mRS ≥3) the good prognostic group(mRS score<3). Plasma Ox-LDL level was measured by enzyme-linked immunosorbent assay(ELISA) at admission and 3 months after discharge. Plasma Ox-LDL level and NIHSS scores were compared between two groups and before and after treatment;Multivariate Logistic regression was used to analyze the influencing factors of poor clinical prognosis. Results: Before and after treatment, the plasma Ox-LDL level in the study group was significantly lower than that in the control group. After treatment, the plasma Ox-LDL level was significantly lower than that before treatment, and the difference was statistically significant(P<0.05);Among the effects of plasma Ox-LDL level on clinical prognosis, Ox-LDL level and NIHSS score were significantly decreased before and after treatment in the group with good prognosis compared with the group with poor prognosis(P<0.05). Conclusion: The application of statins can reduce the plasma Ox-LDL level in patients with acute ischemic cerebral infarction associated with atrial fibrillation and improve the clinical prognosis, which has important clinical value.

关 键 词：他汀类药物 房颤 急性缺血性脑卒中 氧化低密度脂蛋白 临床预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]