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目的观察高血压合并腔隙性脑梗死伴血脂异常患者脂肪细胞因子——内脏脂肪特异性丝氨酸蛋白酶抑制剂(Vaspin)水平的变化,并探讨阿托伐他汀短期治疗对血清Vaspin水平的影响。方法连续入选2015年1-6月于内科门诊就诊并诊断为高血压合并腔隙性脑梗死伴血脂异常的初诊患者128例为治疗组,同期体检健康人群112人为对照组。治疗组患者在常规服用降压药基础上加用阿托伐他汀20mg/d,1次/d,治疗时间4周。用酶联免疫吸附试验(ELISA)法检测治疗组患者治疗前后血清Vaspin水平。结果治疗前,与对照组比较,治疗组患者诊室血压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇(LDL-C)和高敏C反应蛋白(hsCRP)水平明显升高,而高密度脂蛋白胆固醇(HDL-C)和血清Vaspin水平明显降低(均P<0.05)。阿托伐他汀治疗4周后,治疗组患者血压、总胆固醇、三酰甘油、LDL-C和hsCRP水平明显下降,HDL-C和血清Vaspin水平明显升高(均P<0.05)。Pearson相关性分析显示,血清Vaspin水平与收缩压(r=-0.45)、舒张压(r=-0.40)、总胆固醇(r=-0.56)、三酰甘油(r=-0.67)、LDL-C(r=-0.63)和hsCRP(r=-0.53)呈负相关,与HDL-C(r=0.55)呈正相关(均P<0.05)。校正血压和血脂后,多元逐步回归分析显示,hsCRP是血清Vaspin水平的影响因素(β=-1.07,P<0.05)。结论阿托伐他汀短期治疗能提高高血压合并腔隙性脑梗死伴血脂异常患者的血清Vaspin水平。
Objective To observe the changes of adiponectin-visceral fat-specific serine protease inhibitor (Vaspin) in patients with hypertension complicated with lacunar infarction and dyslipidemia and to investigate the effect of short-term treatment with atorvastatin on serum Vaspin levels. Methods One hundred and twenty-eight newly diagnosed patients with hypertension and lacunar infarction with dyslipidemia were enrolled in the Internal Medicine Clinic from January to June in 2015. The control group included 112 healthy subjects in the same period. Patients in the treatment group were given atorvastatin 20 mg once daily for 4 weeks on the basis of conventional antihypertensive drugs. Serum Vaspin levels were measured by enzyme-linked immunosorbent assay (ELISA) in the treatment group before and after treatment. Results Before treatment, the levels of blood pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol (LDL-C) and high sensitivity C-reactive protein (hsCRP) were significantly higher in the treatment group than those in the control group Cholesterol (HDL-C) and serum Vaspin levels were significantly lower (all P <0.05). Four weeks after atorvastatin treatment, blood pressure, total cholesterol, triglyceride, LDL-C and hsCRP levels were significantly decreased and HDL-C and serum Vaspin levels were significantly increased in the treatment group (all P <0.05). Pearson correlation analysis showed that the relationship between serum Vaspin and systolic blood pressure (r = -0.45), diastolic blood pressure (r = -0.40), total cholesterol (r = -0.56), triglyceride (r = -0.67), LDL-C (r = -0.63) was negatively correlated with hsCRP (r = -0.53) and positively correlated with HDL-C (r = 0.55) After adjusting for blood pressure and lipids, multiple stepwise regression analysis showed that hsCRP was the influencing factor of serum Vaspin level (β = -1.07, P <0.05). Conclusion Short-term treatment with atorvastatin can improve the serum Vaspin level in patients with hypertension complicated with lacunar infarction and dyslipidemia.