Study On Prevention Of Depression After Ischemic Stroke With Different Doses Of Pitavastain

Objective:To investigate the preventive effect and safely of different doses of pitavastatin on depression after acute ischemic stroke(AIS),and to discuss the possible mechanism.Methods:AIS patients hospitalized in the Department of Neurology,921th Hospital from January 2020 to November 2020 were selected and divided into three groups: control group(28 cases),conventional dose group(30 cases),enhanced dose group(27 cases).Three groups were treated with AIS routine treatment,scavenging oxygen free radicals(edaravone injection 30mg+NS 100 ml,intravenous drip,twice a day,for two weeks),improving circulation(0.15 units of urinary kallidinogenase injectivon +NS 100 ml,intravenous drip,once a day,for two weeks);anti-platelet aggregation(aspirin enteric-coated tablets 0.1g oral 1/day,clopidogrel hydrogen sulfate tablets 75 mg oral 1/night,for two weeks),etc.The control group was given atorvastatin calcium tablets10 mg oral 1/night for three months,and the conventional dose group and the enhanced dose group were given pitavastain calcium tablets 2mg oral1/night and 4mg 1/night for three months.Use ELISA method to detected interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α),and IFCC method to detected alanine aminotransferase(ALT),aspartate aminotransferase(AST)and creatine kinase(CK)before treatment,2weeks and 3 months after treatment.17 items of the hamilton depression scale(HAMD)scores and National Institute of Health stroke scale(NIHSS)scores were performed in all groups before and after treatment.Results: 1.There was no significant differences in the IL-1β,TNF-αand NIHSS scores between the three groups before treatment.2.After 2 weeks of treatment,the levels of IL-1βand TNF-αof the three groups were lower than before,and the difference was statistically significant;the decrease in the enhanced dose group was more significant than that of the other two groups,and the difference was statistically significant.After 3 months of treatment,IL-1βand TNF-αof the three groups continued to decrease,and there was no significant difference between the three groups.3.After 2 weeks of treatment,the NIHSS scores of the three groups were improved compared to before,and the difference was statistically significant;the enhanced dose group was significantly reduced,and the difference was statistically significant.After 3 months of treatment,the NIHSS scores of three groups were lower than that of 2 weeks of treatment,and the reduction in the enhanced dose group was statistically lower than that of the two groups.4.After 2 weeks of treatment,the incidence of depression in the three groups was no significant difference.After 3 months of treatment,the incidence of depression in the enhanced dose group was significantly lower than that of the other two groups,and the difference was statistically significant.5.Serum IL-1 β and TNF-α are positively correlated with NIHSS scores and depression.Conclusions:1.Pitavastatin has the effect of preventing depression after ischemic stroke.Within a certain period of time,intensive does of pitavastatin has a more significant preventive effect on post-stroke depression without increasing adverse reactions.2.The prevention of post-stroke depression by pitavastatin may be related to reducing serum inflammatory factors and improving NIHSS score in patients with ischemic stroke.