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阿托伐他汀钙联合阿司匹林治疗急性缺血性脑卒中患者的临床疗效及对中性粒细胞、淋巴细胞和白细胞介素-33的影响

Clinical efficacy of atorvastatin calcium combined with aspirin in patients with acute ischemic stroke and effect on neutrophils, lymphocytes and IL-33.

作者信息

Li Wanhui, Ren Xiangyang, Zhang Li

机构信息

Department of Rehabilitation, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan 471009, P.R. China.

Department of Neurology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan 471009, P.R. China.

出版信息

Exp Ther Med. 2020 Aug;20(2):1277-1284. doi: 10.3892/etm.2020.8820. Epub 2020 May 29.

Abstract

Clinical efficacy of atorvastatin calcium combined with aspirin in patients with acute ischemic stroke (AIS) and its effect on neutrophils to lymphocytes ratio (NLR) and interleukin-33 (IL-33) were investigated. In total, 108 patients with AIS in Luoyang Central Hospital Affiliated to Zhengzhou University from April 2016 to October 2017 were selected. There were 56 cases treated with atorvastatin calcium combined with aspirin as the observation group, and 52 cases were treated with aspirin alone as the control group. The clinical effect was observed. The NLR and IL-33 levels were measured by routine blood test and enzyme linked immunosorbent assay (ELISA) before and after treatment. The scores of the National Institutes of Health Stroke scale (NIHSS) and the occurrence of complications were collected before and after treatment in the two groups. Modified Rankin Scale (MRS) was used to evaluate the curative effect. Score ≤2 points is effective in the treatment. Pearson's analysis was used to analyze the correlation between NLR, IL-33 and NIHSS score. The total hospitalization time and 1 year survival rate were compared. The total effective rate of treatment in the observation group was higher than that in the control group (P<0.05). There was no difference in NLR and IL-33 levels between the two groups before treatment (P>0.05). After treatment, the NLR in the observation group was significantly lower than that in the control group (P<0.05). After treatment, the NIHSS score, the total number of complications and the total hospitalization time in the observation group were significantly lower than those in the control group (P<0.05). Pearson's analysis showed a positive correlation between NLR and NIHSS score (r=0.681, P<0.001), and a negative correlation between IL-33 and NIHSS score (r=-0.708, P<0.001). In conclusion, atorvastatin calcium combined with aspirin has a better effective rate in the treatment of acute ischemic stroke than aspirin alone. The combination can better reduce the NLR, increase the expression level of IL-33 in serum, reduce the occurrence of complications and hospitalization time, and increase the survival rate of patients.

摘要

研究阿托伐他汀钙联合阿司匹林治疗急性缺血性脑卒中(AIS)患者的临床疗效及其对中性粒细胞与淋巴细胞比值(NLR)和白细胞介素-33(IL-33)的影响。选取2016年4月至2017年10月在郑州大学附属洛阳中心医院就诊的108例AIS患者。其中56例采用阿托伐他汀钙联合阿司匹林治疗作为观察组,52例仅采用阿司匹林治疗作为对照组。观察临床疗效。治疗前后通过血常规和酶联免疫吸附测定(ELISA)检测NLR和IL-33水平。收集两组治疗前后美国国立卫生研究院卒中量表(NIHSS)评分及并发症发生情况。采用改良Rankin量表(MRS)评估疗效。评分≤2分为治疗有效。采用Pearson分析分析NLR、IL-33与NIHSS评分之间的相关性。比较总住院时间和1年生存率。观察组治疗总有效率高于对照组(P<0.05)。治疗前两组NLR和IL-33水平无差异(P>0.05)。治疗后,观察组NLR显著低于对照组(P<0.05)。治疗后,观察组NIHSS评分、并发症总数和总住院时间均显著低于对照组(P<0.05)。Pearson分析显示NLR与NIHSS评分呈正相关(r=0.681,P<0.001),IL-33与NIHSS评分呈负相关(r=-0.708,P<0.001)。综上所述,阿托伐他汀钙联合阿司匹林治疗急性缺血性脑卒中的有效率优于单用阿司匹林。联合用药能更好地降低NLR,提高血清IL-33表达水平,减少并发症发生和住院时间,提高患者生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e048/7388513/d9eac852f26d/etm-20-02-1277-g00.jpg

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