2020 年第 11 期 第 15 卷

不同剂量辛伐他汀对急性缺血性脑卒中患者血清微小RNA-182和微小RNA-497水平及预后的影响 

The effect of different doses of simvastatin tablets on serum microRNA-182 and microRNA-497 levels and prognosis in patients with acute ischemic stroke

作者：王晓芸1张懿2孙朝荣1杨怡1

英文作者：Wang Xiaoyun1 Zhang Yi2 Sun Chaorong1 Yang Yi1

单位：1上海交通大学医学院附属新华医院药学部200092；2上海市脑血管病防治研究所201318

英文单位：1Department of Pharmacy Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai 200092 China; 2Shanghai Cerebrovascular Disease Prevention and Treatment Institute Shanghai 201318 China

关键词：急性缺血性脑卒中；辛伐他汀；不同剂量；微小RNA

英文关键词：Acuteischemicstroke;Simvastatin;Differentdoses;MicroRNA

• 摘要：

• 目的 探讨不同剂量辛伐他汀对急性缺血性脑卒中（AIS）患者血清微小RNA-182（miR-182）和miR-497水平及预后的影响。方法 选取2018年1月至2019年12月上海交通大学医学院附属新华医院神经内科收治的AIS患者88例，依据治疗中加用他汀药物剂量的不同分为低剂量组（L组，46例)和高剂量组（H组，42例）。L组在常规治疗基础上口服辛伐他汀片20 mg/d；H组在常规治疗基础上口服辛伐他汀片40 mg/d；疗程总计3个月。比较2组患者入院当天及治疗3个月后血清miR-182和miR-497水平、血脂［高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、三酰甘油］水平和神经功能评分［美国国立卫生研究院卒中量表(NIHSS)评分］和生活自理能力评分（Barthel评分）。结果 治疗3个月后，H组血清miR-182、HDL-C水平、Barthel评分明显高于L组［（328±31）fmol/L比（263±25）fmol/L、（1.38±0.43）mmol/L比（1.27±0.32）mmol/L、（72±9）分比（62±7）分］，miR-497、LDL-C及三酰甘油水平和NIHSS评分明显低于L组［（128±25）fmol/L比（320±34）fmol/L、（2.16±0.49）mmol/L比（2.78±0.59）mmol/L、（1.2±0.4）mmol/L比（1.6±0.5）mmol/L、（11.8±1.1）分比（13.8±1.2）分］，差异均有统计学意义（均P＜0.05）。结论 辛伐他汀可调节AIS患者血清miR-182和miR-497水平，并且呈现剂量依赖性。辛伐他汀能够改善AIS患者治疗后神经功能，恢复患者生活自理能力。

• Objective To investigate the effects of different doses of simvastatin on the levels of serum microRNA-182 (miR-182) and miR-497 and prognosis in patients with acute ischemic stroke (AIS). Methods From January 2018 to December 2019, 88 AIS patients admitted to the Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were selected. They were divided into low-dose groups (L group, 46 cases) and high-dose group (H group, 42 cases) according to the dosage of statin added during treatment. Patients in L group were given simvastatin tablets 20 mg/d on the basis of conventional treatment and patients in H group were given simvastatin tablets 40 mg/d on the basis of conventional treatment. Both groups were treated for 3 months. Serum miR-182 and miR-497 levels, blood lipids levels［high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triacylglycerol］ on the day of admission and 3 months after treatment, neurological function score ［National Institutes of Health Stroke Scale (NIHSS) score］ and life self-care ability score (Barthel score) were compared between the two groups. Results After 3 months of treatment, the serum miR-182, HDL-C, and Barthel scores in H group were higher than those in L group［（328±31）fmol/L vs （263±25）fmol/L,（1.38±0.43）mmol/L vs （1.27±0.32）mmol/L,（72±9） vs （62±7）］; the levels of miR-497, LDL-C, triglycerides, and NIHSS scores in H group were lower than those in L group［（128±25）fmol/L vs （320±34）fmol/L,（2.16±0.49）mmol/L vs （2.78±0.59）mmol/L,（1.2±0.4）mmol/L vs （1.6±0.5）mmol/L, （11.8±1.1） vs （13.8±1.2）］ (all P＜0.05). Conclusions Simvastatin can regulate levels of serum miR-182 and miR-497 in patients with AIS, which is dose-dependent. Simvastatin can improve the neurological function of AIS patients after treatment, and restore their self-care ability.