【作者】 宋诗涛；

【导师】 丁琪；

【作者基本信息】 安徽医科大学 ， 老年医学， 2011， 硕士

【摘要】 目的通过检测急性缺血性脑卒中患者使用阿托伐他汀治疗前后外周血中氧化应激和脂质过氧化指标8-iso-PGF2α和ox-LDL的水平,并结合临床参数探讨阿托伐他汀在老年急性缺血性脑卒中患者的治疗过程中的抗氧化应激作用,以期为老年急性缺血性脑卒中患者使用阿托伐他汀抗氧化治疗提供有价值的临床依据。方法收集2009年10月至2010年7月入住安徽省立医院神经内科的年龄在60岁以上的脑梗塞急性期(经CT或/和MRI证实)患者,测定其血压、身高、体重,计算体重指数等;采用美国国立卫生研究院卒中量表(NIHSS)的评分标准对所有患者进行神经功能缺损的评估,纳入中度神经功能缺损的患者共57例,其中试验组30例,接受阿托伐他汀治疗,对照组27例,未予阿托伐他汀(或其他他汀类药物)治疗。所有患者均于入院时及治疗10-14天后清晨空腹抽取外周静脉血2ml,1h内离心分离血浆。采用ELISA(酶标记免疫吸附测定,Enzyme linked immunosorbent assay)方法检测血浆中8-iso-PGF2α和ox-LDL的水平,并进行比对和统计学分析。结果入院治疗10-14天后试验组8-iso-PGF2α和ox-LDL水平较入院时无明显升高,差异无统计学意义,而对照组8-iso-PGF2α和ox-LDL水平较入院时明显升高,差异有统计学意义(p<0.05)。治疗10~14天后试验组与对照组患者血脂各项水平较入院时差异无明显统计学意义(p>0.05)。治疗10~14天后对所有患者再次进行神经功能评估进行疗效评定,结果显示,试验组治疗有效率较对照组高,但两者差异无统计学意义(p>0.05)。结论阿托伐他汀对缺血性脑卒中患者具有调脂作用以外的抗氧化应激和抗脂质过氧化作用。可能对改善老年急性缺血性脑卒中患者临床预后起到积极的作用。更多还原

【Abstract】 Objective To detect the change of plasmic 8 Isoprostan Prostaglandin F2alpha (8-iso-PGF2α) and Oxidized Low Density Lipoprotein(ox-LDL) in the elderly patients with acute cerebral infarction by atorvastatin. To Explain the affect by atorvastatin about Oxidative stress and Lipid peroxidation in Senile Ischemic stroke ,and provide Antioxidant treatment of acute cerebral infarction clinical basis by atorvastatin.Methods Randomly selected 57 cases acute cerebral infarction patients over the age of 60 years,admitted to Neurology of Anhui Provincial Hospital from October in 2009 to July in 2010(Confirmed by CT and MRI),30 cases were treated by atorvastatin, other 27cases were in control group .All blood samples anticoagulated were dealed with centrifugation.All the blood samples were analyzed by enzyme linked immunosorbent assay (ELISA )to detect 8-iso-PGF2αand ox-LDL at admission and after 10~14 days later . They were made comparison and statistical analysis.Results After treated 10~14 days later the test group 8-iso-PGF2αand ox-LDL were not change more .but the control group were changed obviously Their difference have statistically significant(P<0.05). After treated 10~14 days the level of the lipids between the test group and the control group have no statistically significant. After treated 10~14 days ,do neurological for all patients for efficacy evaluation,the result display that the test group’s efficient is higher than the control group’s.but have no statistically significant. Conclusions Atorvastatin have affects in Anti-Oxidative stress and Anti-Lipid peroxidation outside the Lipid Metabolism. Maybe can improve positive affect in eldly acute cerebral infarction for clinical Prognosis.更多还原