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目的观察瑞舒伐他汀对脑出血患者血浆组织因子(tissue factor,TF)和组织因子途径抑制物(tissue factor pathway inhibitor,TFPI)的影响。方法选择2015年1月—2016年1月住院的100例脑出血患者作为病例组,同期选取体检的100名健康受试者作为正常组。将病例组患者随机分为观察组(51例)和对照组(49例)。对照组术后给予常规治疗,如调控血压和脑水肿、调节磷钙代谢、甘露醇静滴等;观察组在此基础上口服瑞舒伐他汀片20 mg治疗,每天1次,持续3个月。比较病例组和正常组血浆TF和TFPI水平;并比较观察组和对照组治疗前后TF、TFPI和血脂水平变化情况。结果治疗前,病例组TF和TFPI水平高于正常组,差异有统计学意义(P<0.05)。治疗前,观察组和对照组的TF、TFPI和血脂水平进行比较,差异无统计学意义;治疗3个月后,观察组TF水平明显低于对照组,TFPI水平明显高于对照组,差异均有统计学意义(P<0.05)。Pearson相关性分析表明TF或TFPI与血脂水平(甘油三酯、总胆固醇、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇)无相关性。观察组和对照组不良反应率比较,差异无统计学意义。结论瑞舒伐他汀治疗术后脑出血患者,能够降低TF水平,提高TFPI水平,对于纠正脑出血患者凝血功能紊乱具有重要意义。
Objective To observe the effect of rosuvastatin on plasma tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in patients with intracerebral hemorrhage. Methods One hundred patients with cerebral hemorrhage hospitalized from January 2015 to January 2016 were selected as the case group and 100 healthy subjects were selected as the normal group during the same period. Patients in the case group were randomly divided into observation group (51 cases) and control group (49 cases). The control group was given routine treatment after surgery, such as regulating blood pressure and cerebral edema, regulating the metabolism of calcium and phosphorus, mannitol intravenous infusion; on the basis of the observation group, 20 mg of rosuvastatin tablets were given once daily for 3 months . The plasma levels of TF and TFPI were compared between the two groups. The levels of TF, TFPI and blood lipid in the observation group and the control group were compared before and after treatment. Results Before treatment, the levels of TF and TFPI in case group were higher than those in normal group (P <0.05). The levels of TF, TFPI and blood lipid in observation group and control group before treatment were no significant difference. After three months of treatment, the level of TF in observation group was significantly lower than that in control group, and the level of TFPI in observation group and control group was significantly higher than that in control group There was statistical significance (P <0.05). Pearson correlation analysis showed no association of TF or TFPI with plasma lipid levels (triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol). There was no significant difference in adverse reactions between the observation group and the control group. Conclusion Rosuvastatin in patients with intracerebral hemorrhage can reduce the level of TF and increase the level of TFPI, which is of great significance for the correction of coagulopathy in patients with intracerebral hemorrhage.