Objective To estimate the effect of ezetimibe on three serum adipokine (chemerin, vaspin and apelin) in obese patients with acute cerebral infarction (ACI). Methods One hundred and fifty patients with ACI were enrolled in this study and they were divided into two group equally and randomly: control group (n=75) and ezetimibe group (n=75). The levels of three adipokine (chemerin, vaspin and apelin) and three neurological score (FMA, NIHSS and Barthel) were measured in two points (before treatment and 4 weeks after treatment). Results Compared with before treatment, 4 weeks later, the levels of chemerin [(57.6±6.2) mg/L vs. (25.3±4.2 )mg/L,t=37.35,P<0.01]and apelin [(177.3±22.6)ng/ml vs. (92.3±16.1) ng/ml,t=26.53,P<0.01] were significantly reduced in ezetimibe group (P<0.05), while levels of vaspin [(6.4±0.8) ng/ml vs.(11.6±1.1) ng/ml,t=33.11,P<0.01] were elevated. Only chemerin[(59.0±5.6) mg/L vs. (43.3±4.3 )mg/L,t=19.26,P<0.01]and vaspin [(6.2±1.2) ng/ml vs. (7.4±0.7) ng/ml,t=7.481,P<0.01] could be found fluctuation after treatment in control group. Compared with control group,4 weeks after treatment, the levels of chemerin[ (25.3±4.2)mg/L vs. (43.3±4.3)mg/L,t=13.95,P<0.01]and apelin[(92.3±16.1)ng/ml vs. (175.8±21.2) ng/ml,t=26.53,P<0.01]were significantly reduced in ezetimibe group,while levels of vaspin[(92.3±16.1)ng/ml vs. (175.8±21.2) ng/ml,t=27.16,P<0.01]were elevated in ezetimibe group. Compared with control group 4weeks after treatment, the level of neurological score(FMA and Barthel)in ezetimibe group were significantly elevated, NIHSS score reduced. Correlation analysis showed that after treatment with ezetimibe the levels of neurological score were negatively associated with chemerin (r=0.635,P<0.05) and apelin (r=0.652,P<0.05), while positively related with vaspin (r=0.606,P<0.05). Conclusion Early administration of ezetimibe may regulate ACI related adiponkine (chemerin, vaspin and apelin) and improve neurological recovery in ACI obesity patients.%目的 观察依折麦布干预治疗对于肥胖急性脑梗死(ACI)患者血清相关脂肪因子--趋化素(chemerin)、丝氨酸蛋白酶抑制剂(vaspin)和脂肪素(apelin)水平的影响.方法 连续性纳入2014年5月-2016年10月徐州医科大学附属淮安医院老年病科住院治疗的肥胖ACI患者150例作为研究对象,采用随机数字表法分为依折麦布组(n=75)和对照组(n=75).分别于治疗前和治疗4周后检测血清脂肪因子(chemerin、vaspin和apelin)水平,并进行神经功能评分(FMA评分、NIHSS评分和Barthel评分).结果 与治疗前比较,治疗4周后,依折麦布组chemerin和apelin水平均明显下降[(57.6±6.2) mg/L vs. (25.3±4.2) mg/L,t=37.35,P<0.01;(177.3±22.6) ng/ml vs. (92.3±16.1) ng/ml,t=26.53,P<0.01],vaspin水平明显上升[(6.4±0.8) ng/ml vs. (11.6±1.1) ng/ml,t=33.11,P<0.01];对照组chemerin明显下降[(59.0±5.6) mg/L vs. (43.3±4.3) mg/L,t=19.26,P<0.01],vaspin明显上升[(6.2±1.2) ng/ml vs. (7.4±0.7) ng/ml,t=7.481,P<0.01].与对照组比较,治疗4周后,依折麦布组chemerin和apelin水平低于对照组,vaspin水平高于对照组(P均<0.01).治疗4周后,2组患者FMA运动评分、FMA平衡评分和Barthel评分均升高(P<0.01),NIHSS评分均降低(P<0.01),且依折麦布组改善均优于对照组(P<0.01).肥胖ACI患者依折麦布干预后功能评分与△chemerin和△apelin呈负相关(r=-0.635、-0.652,P<0.05),与△vaspin呈正相关(r=0.606,P<0.05).结论 肥胖ACI患者及早应用依折麦布干预治疗可以明显改善ACI相关脂肪因子chemerin、 vaspin和apelin的水平异常,加快脑梗死后神经功能恢复.
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