[1]高菊华,高小平,潘速跃.阿托伐他汀强化治疗可减少大脑中动脉支架置入后脑血管事件的发生[J].南方医科大学学报,2016,(03):356.
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阿托伐他汀强化治疗可减少大脑中动脉支架置入后脑血管事件的发生()
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《南方医科大学学报》[ISSN:1673-4254/CN:44-1627/R]

卷:
期数:
2016年03期
页码:
356
栏目:
出版日期:
2016-03-20

文章信息/Info

Title:
Perioperative intensive statin therapy improves outcomes in patients with ischemic stroke undergoing middle cerebral artery stent implantation
作者:
高菊华高小平潘速跃
关键词:
脑梗死大脑中动脉支架植入术sCD147阿托伐他汀
Keywords:
cerebral infarction MCAstent implantation sCD147 atorvastatin
摘要:
目的观察已接受长期他汀治疗的脑梗死患者,大脑中动脉(middle cerebral artery, MCA)支架植入围手术期服用负荷剂 量的阿托伐他汀对其近期脑血管事件的影响及机制探讨。方法选择2010年1月~2014年11月在我科接受大脑中动脉支架植 入术的脑梗死患者40例。随机分为强化组(术前使用阿托伐他汀80 mg/d预处理3 d,术后原剂量巩固3 d,之后20 mg/d维持) 和对照组(同期均匀给予阿托伐他汀20 mg/d),每组20例。抽血检测术前24 h、术后24 h血清high-sensitive C-reactive protein (hs-CRP)、soluable extracellular matrix metalloproteinase inducer(EMMPRIN/CD147)及soluable vascular cell adhesion molecule-1(sVCAM-1)水平变化;术后1个月行神经专科及DSA随访,观察主要终点事件(支架内急性血栓形成、再狭窄、短暂 性脑缺血发作、脑梗死复发、再次介入治疗及死亡)的发生情况。结果两组术前24h各指标无差异(P>0.05)。强化组术后24 h 血清hs-CRP、sCD147及sVCAM-1水平显著低于对照组(P<0.05);强化组血清hs-CRP、sCD147及sVCAM-1水平在支架植入术 后较术前显著下降(P<0.05)。对照组术后较术前有一定程度的升高(P>0.05);术后1个月强化组主要终点事件发生率显著低于 对照组(P<0.05)。结论对于已接受长期他汀治疗的脑梗死患者,大脑中动脉支架植入围手术期服用负荷剂量的阿托伐他汀能 显著降低血清hs-CRP、sCD147及sVCAM-1水平,减少脑血管事件的发生。
Abstract:
Objective To investigate whether intensive statin therapy during the perioperative period improves outcomes in patients undergoing middle cerebral artery (MCA) stent implantation for ischemic stroke. Methods Forty patients with ischemic stroke undergoing delayed stent implantation in our department from January, 2010 to November, 2014 were randomized to intensive statin group (atorvastatin, 80 mg/day, 3 days before till 3 days after intervention; n=20) and standard therapy group (atorvastatin, 20 mg/day, n=20). All the patients received long-term atorvastatin treatment thereafter (20 mg/ day). Serum levels of C-reactive protein (CRP), vascular cell adhesion molecule-1 (VCAM-1), and soluble extracellular matrix metalloproteinase inducer (EMMPRIN/CD147) were measured at 24 h before and 24 h after the intervention. The primary end point was procedure-related intra-stent thrombosis, 1-month incidence of major adverse cerebrovascular events (stroke, transient ischemic attack, in-stent restenosis, death or unplanned revascularization). Results The basic clinical data were similar between the two groups before the intervention (P>0.05). In the intensive therapy group, the levels of CRP, VCAM-1, and sCD147 were significantly lower at 24 h after the intervention than the levels before intervention (P<0.05) and the postoperative levels in the standard therapy group (P<0.05). The levels of CRP, VCAM-1, and sCD147 were all increased after the intervention in the standard therapy group (P>0.05). The incidence of primary end point was lower in intensive therapy group than in standard therapy group (P<0.05). Conclusion In patients undergoing MCA intravascular stent implantation for ischemic stroke, perioperative intensive statin therapy improves the patients’ outcomes, reduces the levels of CRP, VCAM-1 and sCD147 molecules, and lowers the incidences of cerebrovascular events.

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更新日期/Last Update: 1900-01-01