早期阿托伐他汀强化治疗急性脑梗的短期疗效及对外周血内MMP-9水平的影响

摘要

目的 考察早期阿托伐他汀强化治疗急性脑梗死的短期疗效及对外周血内基质金属蛋白酶9(MMP-9)水平的影响.方法 采集2015年1月至2015年12月我院收治的急性脑梗死患者330例,随机分为强化他汀组(165例)和常规剂量他汀组(165例),常规剂量他汀组给予阿托伐他汀钙片,20 mg/d,强化他汀组给予阿托伐他汀钙片,40 mg/d,两组患者均持续用药14 d.采用酶联免疫吸附测定法(enzyme-linked immunosorbent assay,ELISA)检测两组患者的MMP-9的水平,并比较治疗前及治疗后7d和14 d的日常生活能力量表Barthel评分、美国国立卫生院神经功能缺损(NIHSS)评分及Fugl-Meyer运动功能(FMA)评分.结果 强化他汀组在治疗后7d和14 d的Barthel评分和FMA评分与常规剂量他汀组相比显著提高,NIHSS评分显著降低,差异有统计学意义(P＜0.05);与常规剂量他汀组相比,强化他汀组在治疗后7d和14 d MMP-9的水平均显著降低(P＜0.05),表明应用阿伐他汀强化治疗可以有效改善急性脑梗患者的神经功能缺损情况,提高患者的运动功能和生活自理能力.结论 早期阿托伐他汀钙强化治疗可降低急性脑梗死患者的血清MMP-9水平,促进患者神经功能的恢复,同时可提高患者的日常生活能力和运动能力,短期疗效显著.%Objective To investigate the short-term efficacy and influence on the level of (matrix metalloproteinase-9) MMP-9 in the peripheral blood by early stage atorvastatin intensive treatment for acute cerebral infarction (ACI).Methods 330 patients with acute cerebral infarction were collected from January 2015 to December 2015 in our hospital,and randomly divided into intensive statin treatment group (165 cases) and conventional dose of statin group (165 cases).Conventional dose of statin group was given atorvastatin calcium tablets 20 mg every day,intensive statin treatment group was given atorvastatin calcium tablets,40 mg every day,both for 14 days.The Enzyme-linked immunosorbent assay (ELISA) method was used to detect the level of MMP-9 between two groups,and the Barthel Index,National Institutes of Health Stroke Scale (NIHSS) and Fugl-Meyer assessment scale (FMA) were compared before and 7 d,14 d after given atorvastatin calcium tablets.Results The Barthel and FMA of intensive statin treatment group were higher than conventional dose of statin group,and the NIHSS of intensive statin treatment group was lower than conventional dose of statin group,the differences were statistically significant (P＜0.05).Compared with the conventional dose of statin group,the level of MMP-9 of intensive statin treatment group significantly decreased after 7 d,14 d given atorvastatin calcium tablets 40 mg/d (P＜0.05),which indicated that the atorvastatin therapy could effectively improve neurological function in patients with acute cerebral infarction,improved the motor function and self-care ability.Conclusion Early stage atorvastatin intensive treatment can reduce the level of serum MMP-9 of acute cerebral infarction patients,promote the recovery of neural function,meanwhile,improve the ability of daily life and exercise,short term therapeutic effect is obvious.