早期物理治疗联合阿托伐他汀对急性缺血性卒中患者血清脑源性神经营养因子水平和神经功能的影响：随机对照研究  

Effects of early physiotherapy in combination with atorvastafin on the levels of sennn brain-derived neurotrophic factor and neurological function in patients with acute ischemic stroke： a randomized controlled study

作　　者：李影[1] 黄永璐[2] 张敬苗[1] 瞿萍[1] 高宗良[1] 

机构地区：[1]安徽医科大学第二附属医院神经内科,合肥230601 [2]安徽医科大学临床学院,合肥230001

出　　处：《国际脑血管病杂志》2014年第1期39-43,共5页International Journal of Cerebrovascular Diseases

基　　金：国家自然科学基金（81000534）

摘　　要：目的探讨早期物理治疗联合阿托伐他汀对急性缺血性卒中患者血清脑源性神经营养因子（brain—derivedneurotrophicfactor，BDNF）水平和神经功能的影响。方法50例急性缺血性卒中患者随机分为阿托伐他汀组（单用组，25例）和早期物理治疗联合阿托伐他汀组（联用组，25例）。所有患者均根据缺血性卒中诊治指南给予规定药物，单用组加用阿托伐他汀钙（20mg，每晚1片），联用组在单用组基础上给予早期物理治疗。在治疗前以及治疗2周和6周时采用双抗体夹心酶联免疫吸附试验检测血清BDNF水平，采用美国国立卫生研究院卒中量表（NationalInstitutesofHeaRhStrokeScale，NIHSS）评定神经功能缺损程度，Barthel指数（BarthelIndex，BI）评定日常生活活动能力，改良Rankin量表（modifiedRankinScale，mRS）评定残疾程度。结果单用组和联用组人口统计学和基线资料均无显著性差异。两组治疗后NIHSS、13I和mRS评分均显著性优于治疗前（P均〈0．001），治疗前和治疗2周时两组间NIHSS、BI和mRS评分均无显著性差异，但在治疗6周时，联用组NIHSS[（2．40±1．38）分对（3．36±1．73）分，P=0．035]和mRS评分[（1．40±0．87）分对（1．96±0．94）分，P=0．047]显著性低于单用组，BI评分[（92．60±7．50）分对（85．20±11．68）分，P=0．011]显著性高于单用组。两组治疗后血清BDNF水平均显著性增高，各时间点之间差异有显著性（P均〈0．001）；联用组血清BDNF水平在治疗2周时[（3．07±0．93）ng／ml对（2．45±0．76）ng／ml；t=2．559，P=0．014]和6周时[（2．90±0．93）ng／ml对（2．31±0．77）ng／ml；t=2．433，P=0．019]均显著高于单用组。Spearman相关性分析显示，血清BDNF水平与NIHSS（r=-0．738，P〈0．001）和mRS评分（r=-0．654，P〈0．001）呈显著性负相关，而与Bl评分呈显著性正相关（r=0．716，P〈0．001）。两组�Objective To investigate the effects of early physiotherapy in combination with atorvastatin on the levels of serum brain-derived neurotrophic factor （BDNF） and neurological function in patients with acute ischemic stroke. Methods Fifty patients with acute ischemic stroke were randomly divided into either an atorvastatin group （monotherapy group, n =25） or a early physiotherapy ＋ atorvastatin group （combination treatment group, n = 25 ）. All patients received the prescr^ed drugs according to the diagnosis and treatment guidelines for ischemic stroke. The monotherapy group added atorvastatin calcium （20 rag, 1 tablet every night orally）. On the basis of the monotherapy group, the combination treatment group also conducted early physical therapy. At 2 and 6 weeks before and after treatment, a double-antibody sandwich enzyme-linked immunosorbent assay was used to detect the serum BDNF levels. The National Institutes of Health Stroke Scale （NIHSS） was used to evaluate the degree of neurological deficit. Barthel index （BI） was used to evaluate the activities of daily living. The modified Rankin scale （mRS） was used to assess the degree of disability. Results There was no significant difference in demographics and baseline data between the monotherapy group and the combination treatment group. The scores of NIHSS, BI, and mRS in both groups after treatment were significantly better than those before treatment （all P 〈 0. 001）. There were no difference in the scores of NIHSS, BI and mRS at 2 weeks before and after treatment, but at 6 weeks after treatment, the scores of NIHSS （2.4± 1.38 vs. 3.36±1.73; P =0. 035） and mRS （1.40 ±0.87 vs. 1. 96±0. 94; P =0. 047） of the combination treatment group were significantly lower than those of the monotherapy group, and the BI scores （92.60±7.50 vs. 85.20±11.68; P=0. 011） were significantly higher than those of the monotherapy group. After treatment, the serum BDNF levels were increased significantly in both groups. There were s

关 键 词：卒中 脑缺血 羟甲基戊二酰基COA还原酶抑制剂 阿托伐他汀 物理治疗方法 脑源性神经营养因子 

分 类 号：R743.3[医药卫生—神经病学与精神病学]