The clinical efficacy and influence of atorvastatin and urinary kallidinogenase on endothelin and inflammato-ry mediators in the treatment of elderly patients with acute cerebral infarction / 中国基层医药

ABSTRACT

Objective To observe the clinical efficacy and influence of atorvastatin and Urinary Kallidinoge-nase on rheology,endothelin and inflammatory mediators in the treatment of elderly patients with acute cerebral infarc-tion,and to guide clinical treatment.Methods 86 patients with acute cerebral infarction were randomly divided into 43 cases of the observation group and 43 cases of the control group.Both groups were given conventional therapy,then the control group were given atorvastatin(20mg/d,qd),the observation group were given atorvastatin(20mg/d,qd) and Urinary Kallidinogenase(0.15PNA /time).2 weeks were set for a course of treatment,NIHSS score and ADL score were calculated before and after treatment.Then endothelin,CRP,IL -1 and hemorheology were measured by phlebotomized when limosis to evaluated the efficacy.Results The high shear whole blood viscosity,erythrocyte ag-gregation index,hematocrit,fibrinogen,erythrocyte sedimentation rate,endothelin,CRP,IL -1 and NHISS of the ob-servation group and control group after treatment were respectively (3.45 ±0.21)mpa/s vs.(4.89 ±0.31)mpa/s, (4.05 ±0.56)vs.(6.43 ±0.63),(33.4 ±3.4)% vs.(39.8 ±3.7)%,(2.43 ±0.72)g/mL vs.(3.18 ±0.64)g/mL,(20.5 ±7.5)mm/h vs.(27.3 ±7.3)mm/h,(58.8 ±5.7)pg/L vs.(70.7 ±7.5)pg/L,(6.68 ±2.96)mg/L vs.(16.78 ±8.97)mg/L,(3.64 ±1.56)ng/L vs.(6.53 ±2.64)ng/L,(8.2 ±3.3)point vs.(15.5 ±6.3)point. Data of both groups were significantly lower than before treatment,(t =5.234 vs.4.267,4.627 vs.3.532,4.872vs.3.726,5.021 vs.3.429,6.046 vs.3.848,10.477 vs.6.818,11.557 vs.6.686,9.267 vs.6.421,12.712 vs. 5.044,all P <0.05).The ADL score were (28.7 ±11.2)point vs.(22.5 ±10.1)point,and the data of both groups were significantly higher than before treatment (t =8.396 vs.5.336,all P <0.05).The high shear whole blood vis-cosity,erythrocyte aggregation index,hematocrit,fibrinogen,erythrocyte sedimentation rate,endothelin,CRP,IL -1 and NHISS of the observation group were significantly lower than the control group(t =3.207,3.388,3.667,3.761, 3.959,3.929,3.884,3.304,3.778,all P <0.05).The ADL score of the observation group were significantly higher than the control group(t =3,447,P <0.05);The total effective rate of the observation group and control group were 95.35% (41 /43 )vs 69.77% (30 /43 ),the difference was statistically significant (χ2 =10.904,P <0.05 ). Conclusion The method contained atorvastatin and urinary kallidinogenase have exact clinical efficacy,can improve neurological deficit assessment and the ability of daily life.Its mechanism may be that it can reduce endothelin levels of inflammatory mediators and improve blood circulation,which is worthy of clinical use.