摘要
目的研究早期肠内营养支持联合阿托伐他汀对缺血性脑卒中患者神经功能恢复及免疫功能的影响。方法选取2018年2月至2019年2月期间延安大学附属医院心脑血管病医院收治的82例缺血性脑卒中患者,按照随机数表法均分为观察组(早期肠内营养支持联合阿托伐他汀治疗)和对照组(阿托伐他汀治疗)各41例。比较两组患者治疗14 d后的临床疗效,以及治疗前、治疗14 d后的神经功能[美国国立卫生院卒中量表(NIHSS)]、免疫功能[免疫球蛋白G (IgG)、IgM、IgA]、炎症相关因子[肿瘤坏死因子(TNF-α)、白细胞介素-6 (IL-6)、IL-8]、卒中相关因子[S-100β、淀粉样蛋白A (SAA)、脂蛋白相关磷脂酶A2 (Lp-PLA2)]水平。结果观察组患者的治疗总有效率为65.85%,与对照组的56.10%比较差异无统计学意义(P>0.05);治疗14 d后,观察组患者的NIHSS评分为(8.43±0.83)分,对照组NIHSS评分为(8.71±0.88)分,两组治疗后NIHSS评分均较治疗前明显下降,差异有统计学意义(P<0.05),但治疗14 d后两组间的NIHSS评分比较差异无统计学意义(P>0.05);治疗14 d后,两组患者的IgG、TNF-α、IL-6、IL-8、S-100β、SAA、Lp-PLA2水平均较治疗前明显下降,且观察组明显低于对照组,差异均有统计学意义(P<0.05);治疗14 d后,两组患者的IgM、IgA水平均较治疗前明显上升,且观察组IgM、IgA水平分别为(2.63±0.75) g/L、(4.25±1.36) g/L,明显高于对照组的(1.34±0.33) g/L、(3.31±0.95) g/L,差异均有统计学意义(P<0.05)。结论早期肠内营养支持联合阿托伐他汀能够有效促进缺血性脑卒中患者神经功能恢复,改善免疫功能,降低机体炎症水平,改善患者预后。
Objective To study the effects of early enteral nutrition support combined with atorvastatin on neu-rological function recovery and immune function in patients with ischemic stroke.Methods Eighty-two patients with ischemic stroke who were treated in Cardio-cerebrovascular Hospital of Yan'an University Affiliated Hospital from February 2018 to February 2019 were selected and divided into observation group(early enteral nutrition support combined with atorvastatin)and control group(atorvastatin treatment)according to the random number table method,with 41 pa-tients in each group.The efficacy of the two groups was compared after 14 d of treatment.The neurological function(Na-tional Institutes of Health Stroke Scale[NIHSS]),immune function(immunoglobulin G[IgG],IgM,IgA),inflamma-tion-related factors(tumor necrosis factor[TNF-α],interleukin-6[IL-6],IL-8),and stroke-related factors(S-100β,am-yloid A[SAA],lipoprotein-associated phospholipase A2[Lp-PLA2])were recorded before treatment and after 14 d of treatment.Results There was no statistically significant difference in the total effective rate of treatment in observation group compared with that in control group(65.85%vs 56.10%,P>0.05).After 14 d of treatment,the NIHSS score was(8.43±0.83)points in the observation group and(8.71±0.88)points in the control group;the NIHSS points in the two groups after treatment were significantly decreased compared with those before treatment(P<0.05),and there was no sta-tistically significant difference between the two groups after 14 d of treatment(P>0.05).After 14 d of treatment,the lev-els of IgG,TNF-α,IL-6,IL-8,S-100β,SAA,and Lp-PLA2 in the two groups were significantly decreased compared with those before treatment,and the levels in observation group were significantly lower than those in control group(P<0.05).After 14 d of treatment,the levels of IgM and IgA in the two groups were significantly increased compared with those before treatment,and the levels in observation group were significantly higher than those in control group:(2.63±0.75)g/L vs(1.34±0.33)g/L,(4.25±1.36)g/L vs(3.31±0.95)g/L,P<0.05.Conclusion Early enteral nutrition support combined with atorvastatin for patients with ischemic stroke can effectively promote the neurological function recovery,improve immune function,reduce the body inflammation,and promote the prognosis of patients.
作者
韩刚
刘娟娟
李转霞
HAN Gang;LIU Juan-juan;LI Zhuan-xia(Department of Neurocritical Medicine,the Cardio-cerebrovascular Hospital of Yan'an University Affiliated Hospital,Yan'an 716000,Shaanxi,CHINA;Department of General Medicine,the Cardio-cerebrovascular Hospital of Yan'an University Affiliated Hospital,Yan'an 716000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2020年第11期1365-1368,共4页
Hainan Medical Journal
关键词
早期肠内营养支持
阿托伐他汀
缺血性脑卒中
神经功能恢复
免疫功能
Early enteral nutrition support
Atorvastatin
Ischemic stroke
Neurological function recovery
Im-mune function
