To explore influence of dual antiplatelet therapy combined different dose of atorvastatin calci‐um on serum levels of monocyte chemoattractant protein (MCP)‐1 and vascular endothelial cadherin (VE‐cadherin) in patients with acute cerebral infarction atorvastatin routine dose group (ACI).Methods :A total of 119 ACI patients admitted in our hospital from 2016 to 2017 were randomly divided into atorvastatin routine dose group (n＝61) and large dose group (n＝58 ,40mg ,once／d) ,both groups received routine treatment and aspirin + clopidogrel for 30d. NIHSS ,serum levels of hsCRP ,TNF‐α ,IL‐8 ,MCP‐1 and VE‐cadherin ,carotid atherosclerotic plaque size and IMT before and after treatment ,and incidence of adverse reactions were measured and compared between two groups . Results :Compared with before treatment ,there was significant reduction in NIHSS score after 15d and 30d in two groups ,and those of 30d were significantly lower than those of 15d ,P＝0. 001 all ;compared with routine dose group after 15d and 30d ,there was significant reduction in NIHSS score [15d :(5.32 ± 1. 63 ) scores vs .(4. 13 ± 1.25 ) scores] in large dose group ,P＝ 0.001 ;Compared with routine dose group after 30d ,there were significant reduc‐tions in serum levels of hsCRP [(9.37 ± 1.85)mg／L vs.(6. 35 ± 1.94)mg／L] ,TNF‐α[(10. 15 ± 2.47)μg／L vs.(7. 44 ± 1.94)μg／L ] ,IL‐8 [(20. 35 ± 4.48 )μmol／L vs.(15. 14 ± 3. 61 ) μmol／L ] ,MCP‐1 [(234.54 ± 32. 53 ) ng／L vs. (185.46 ± 29. 47) ng／L] ,VE‐cadherin [(5. 32 ± 0. 49)mg／L vs.(4. 18 ± 0.54) mg／L] ,plaque size [(17.25 ± 3.14) mm2 vs.(14.13 ± 2.07)mm2 ] and IMT[(1.08 ± 0.25)mm vs.(0.85 ± 0. 17)mm] in large dose group ,P＝0.001 all. There was no significant difference in incidence rate of adverse reaction between two groups .Conclusion :Large dose atorvastatin combined dual antiplatelet therapy can significantly reduce serum levels of MCP‐1 and VE‐cadherin ,im‐prove brain function without increasing incidence rate of adverse reactions .%目的 探讨双联抗血小板治疗联合不同剂量阿托伐他汀钙对急性脑梗塞(ACI)患者血清单核细胞趋化因子(MCP)‐1 、血管内皮细胞钙黏蛋白(VE‐cadherin )水平的影响.方法 2016年至2017年在我院就诊的119例ACI患者被随机分为阿托伐他汀常规剂量组(常规剂量组,61例)和阿托伐他汀大剂量组(大剂量组,58例,40mg ,1次／d) ,两组均接受常规和阿司匹林+氯吡格雷治疗,两组均治疗30d .治疗前后测量比较两组NIHSS 、hsCRP 、TNF‐α 、IL‐8 、MCP‐1 、VE‐cadherin水平、颈动脉粥样硬化斑块面积和IMT ,以及治疗中的不良反应.结果 与治疗前比较,两组治疗15d 、30d后NIHSS评分均显著降低,且30d的显著低于15d的,P均＝0. 001 ;与常规剂量组比较,大剂量组治疗15d 、30d后的NIHSS评分[15d (5. 32 ± 1.63)分比(4.13 ± 1. 25)分]降低更显著,P均＝0. 001 .与常规剂量组比较,治疗30d后大剂量组血清hsCRP[(9.37 ± 1. 85)mg／L比(6. 35 ± 1. 94)mg／L] 、TNF‐α[(10. 15 ± 2.47)μg／L比(7. 44 ± 1.94)μg／L] 、IL‐8[(20. 35 ± 4.48)μmol／L比(15.14 ± 3.61)μmol／L] 、MCP‐1[(234.54 ± 32. 53)ng／L比(185. 46 ± 29. 47) ng／L] 、VE‐cadherin [(5.32 ± 0. 49 )mg／L比(4.18 ± 0. 54 )mg／L ]水平、斑块面积[(17.25 ± 3. 14 )mm2比(14.13 ± 2.07)mm2 ]和IMT[(1.08 ± 0.25)mm比(0. 85 ± 0.17)mm]降低更显著,P均＝0.001 .两组不良反应发生率无显著差异.结论 大剂量阿托伐他汀联合双联抗血小板治疗可显著降低血清MCP‐1和VE‐cadherin水平,改善脑功能,并未增加不良反应率,值得临床推广.
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